Emergency Medical Services Outcomes Project (EMSOP) IV: pain measurement in out-of-hospital outcomes research.
The purpose of the Emergency Medical Services Outcomes Project (EMSOP) is to develop a foundation and framework for out-of-hospital outcomes research. In prior work (EMSOP I), discomfort had the highest weighted score among outcome categories for the top 3 adult conditions (ie, minor trauma, respiratory distress, chest pain) and the first and third highest rankings for children's conditions (ie, minor trauma, respiratory distress). In this fourth article in the EMSOP series, we discuss issues relevant to the measurement of pain in the out-of-hospital setting, recommended pain measures that require evaluation, and implications for outcomes research focusing on pain. For adults, adolescents, and older children, 2 verbal pain-rating scales are recommended for out-of-hospital evaluation: (1) the Adjective Response Scale, which includes the responses "none," "slight," "moderate," "severe," and "agonizing," and (2) the Numeric Response Scale, which includes responses from 0 (no pain) to 100 (worst pain imaginable). The Oucher Scale, combining a visual analog scale with pictures, seems most promising for out-of-hospital use among younger children. Future research in out-of-hospital care should be conducted to determine the utility and feasibility of these measures, as well as the effectiveness of interventions for pain relief.
Maio
Ronald F
RF
Department of Emergency Medicine, University of Michigan Medical Center, Ann Arbor, MI 48109, USA. ronmaio@umich.edu
Garrison
Herbert G
HG
Spaite
Daniel W
DW
Desmond
Jeffrey S
JS
Gregor
Mary Ann
MA
Stiell
Ian G
IG
Cayten
C Gene
CG
Chew
John L
JL
Mackenzie
Ellen J
EJ
Miller
David R
DR
O' Malley
Patricia J
PJ
D000328:Adult; D002648:Child; D004632:Emergency Medical Services / Q000379:methods*; D006801:Humans; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000175:diagnosis* / Q000209:etiology; D010147:Pain Measurement / Q000379:methods*; D014947:Wounds and Injuries / Q000150:complications