An interventional study to improve the quality of analgesia in the emergency department.
OBJECTIVE
We sought to document the adequacy of acute pain management in a high-volume urban emergency department and the impact of a structured intervention.


METHODS
We conducted a prospective, single-blind, pre- and postintervention study on patients who suffered minor-to-moderate trauma. The intervention consisted of structured training sessions on emergency department (ED) analgesia practice and the implementation of a voluntary analgesic protocol.


RESULTS
Preintervention data showed that only 340 of 1000 patients (34%) received analgesia. Postintervention data showed that 693 of 700 patients (99%) received analgesia, an absolute increase of 65% (95% CI 61%-68%), and that delay to analgesia administration fell from 69 (standard deviation [SD] 54) minutes to 35 (SD 43) minutes. Analgesics led to similar reductions in visual analog pain scale ratings during the pre- and postintervention phases (4.5 cm, SD 2.0 cm, and 4.3 cm, SD 3.0 cm, respectively).


CONCLUSIONS
Our multifaceted ED pain management intervention was highly effective in improving quality of analgesia, timeliness of care and patient satisfaction. This protocol or similar ones have the potential to substantially improve pain management in diverse ED settings.
Yanuka
Michael
M
Department of Emergency Medicine, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Soffer
Dror
D
Halpern
Pinchas
P
D000700:Analgesics / Q000008:administration & dosage*; D016001:Confidence Intervals; D004636:Emergency Service, Hospital / Q000592:standards*; D006801:Humans; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D016037:Single-Blind Method
D000700:Analgesics