title: Pain management in emergency departments: a review of present protocols in The Netherlands.
abstract: This descriptive study presents availability and content of acute pain protocols in emergency departments (EDs) in The Netherlands. Current acute pain protocols were collected and an a priori list of questions was used for analysis. Findings were compared with current international standards. Sixty-six of the 108 EDs responded. Fifty-six percent of the protocols did not address adults and 35% did not address children. Protocols were rather conservative and showed poor multidisciplinary approach. Seventy-three percent required a diagnosis before pain relief. Six percent did not include opioids, 36% did not allow intravenous opioids and only 49% allowed direct administration of opioids in severe pain. Pain measurement was included in 55% and in only 5% a target score was defined. Nonpharmacological approaches were mentioned in 6%. Acute pain protocols are lacking in many EDs. Most protocols did not apply current standards. We exposed an area with space for leadership.
authors.affiliation: Department of Emergency Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands. M.Gaakeer@asz.nl
authors.forename: Menno I
authors.initials: MI
authors.lastname: Gaakeer
authors.forename: Joris M
authors.initials: JM
authors.lastname: van Lieshout
authors.forename: Joost J L M
authors.initials: JJ
authors.lastname: Bierens
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000367:Age Factors; D000701:Analgesics, Opioid / Q000627:therapeutic use; D002648:Child; D002985:Clinical Protocols; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands; D010146:Pain / Q000188:drug therapy* / Q000517:prevention & control; D010147:Pain Measurement; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid