Pain in the emergency department: adherence to an implemented treatment protocol.
OBJECTIVE
Although pain is one of the most common presenting complaints in the Emergency Department (ED), pain management is often inadequate. Pain management protocols have been shown to be useful. The objective of this study was to assess the adherence to an already implemented pain management protocol in an urban ED.


METHODS
Secondary analysis of a prospective single centre cohort study on patient preferences for analgesia in the ED. Patient charts were reviewed with a focus on selection, timing and dosage of analgesics according to a visual analogue scale (VAS) on arrival and during the ED stay.


RESULTS
Three hundred and thirty-seven patient charts were reviewed. The adherence to the implemented pain management protocol was 42% at the time of initial evaluation and 43% during the course of therapy in all patients. Forty-two percent of the study population were discharged with at least moderate pain. However, 43% of the patients discharged with pain did not request analgesics.


CONCLUSIONS
The benefits of pain management protocols are proven. However, adherence to these protocols needs to be monitored regularly in order to optimise pain management.
Stephan
Frank-Peter
FP
Department of Emergency Medicine, University Hospital, Basel, Switzerland.
Nickel
Christian H
CH
Martin
Jaqueline S
JS
Grether
Daniela
D
Delport-Lehnen
Karen
K
Bingisser
Roland
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage* / Q000627:therapeutic use; D002985:Clinical Protocols; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy*; D059408:Pain Management; D010147:Pain Measurement; D011446:Prospective Studies; D013997:Time Factors; D014944:World Health Organization; D055815:Young Adult
D000700:Analgesics