title: Acute pain is underassessed in out-of-hospital emergencies.
abstract: OBJECTIVE
  To evaluate the quality of pain assessment by emergency medical services (EMS) in out-of-hospital emergencies.
  
  
  METHODS
  A prospective study was conducted on a convenience sample of patients during a one-year observation period. Pain ratings assessed by emergency patients were documented at three different intervals during the emergency call, and compared with concomitant assessments by EMS providers. A visual analog scale (VAS) and a verbal pain scale (VPS) were used for pain assessment. Repeated-measures ANOVA and Dunnett's t-test were used for data analysis.
  
  
  RESULTS
  Fifty-one out of 70 eligible patients met inclusion criteria. In most emergency patients the intensity of pain was underestimated by EMS, especially when pain was severe (p = 0.0001). During the course of transport, both pain and pain assessment by EMS improved significantly (p = 0.0001). The VAS and VPS were significantly correlated (p = 0.0001).
  
  
  CONCLUSIONS
  EMS providers significantly underestimate their patients' pain severity. EMS providers should be more attentive to their patients' complaints and comfort.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, University of Innsbruck, Austria.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Luger
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Lederer
authors.forename: Michael
authors.initials: M
authors.lastname: Gassner
authors.forename: Alexander
authors.initials: A
authors.lastname: Löckinger
authors.forename: Hanno
authors.initials: H
authors.lastname: Ulmer
authors.forename: Ingo H
authors.initials: IH
authors.lastname: Lorenz
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D002983:Clinical Competence / Q000706:statistics & numerical data; D015331:Cohort Studies; D004632:Emergency Medical Services / Q000592:standards* / Q000706:statistics & numerical data; D004634:Emergency Medical Technicians / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000145:classification; D010147:Pain Measurement / Q000592:standards* / Q000706:statistics & numerical data; D010820:Physicians / Q000706:statistics & numerical data; D011446:Prospective Studies; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D013995:Time; D014187:Transportation of Patients / Q000706:statistics & numerical data