title: Pain management of trauma patients in the emergency department: a study in a public hospital in Iran.
abstract: BACKGROUND
  Pain is a common problem which the patients in emergency departments (ED) face, especially trauma patients under treatment may suffer from physical, psychological and ethical issues. The purpose of this study was to evaluate traumatic pain management in the emergency department at a public hospital in Iran in 2014.
  
  
  METHODS
  This observational prospective study was conducted on 450 trauma patients admitted to a trauma emergency department. The tool used in this study has three parts: demographic data, data of trauma, and VRS (Verbal Rating Scales) score at a 7-point scale-at the arrival time to 4h later. The statistical analysis was conducted by using Mann-Whitney and Kruskal-Wallis tests, repeated measures, survival analysis, and multiple regression analysis.
  
  
  RESULTS
  The majority of the samples were male (83.3%) with the mean age of 35.2years. The patients mostly suffered from contusions and strains (42.4%). The majority of the patients [274 patients (60.8%)] received no intervention for pain relief and only 60 patients (13.3%) received analgesics. The mean time period of the first analgesic utilization was 41 (±20.4) minutes. Pain in admission, pain assessment, and receiving intervention could explain the 32% of pain reduction. No other variables such as age, sex, education, kind of trauma, and the shift of admission were involved in pain reduction.
  
  
  CONCLUSIONS
  This research study demonstrated that comprehensive, adequate pain management remains an obscure goal within the emergency nursing setting. There is a need to undertake further research and develop educational programs on effective analgesic practice in pain management.
authors.affiliation: Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran. Electronic address: masudialavi_N@kaums.ac.ir.
authors.forename: Negin
authors.initials: N
authors.lastname: Masoudi Alavi
authors.affiliation: Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran. Electronic address: ms_aboutalebi@yahoo.com.
authors.forename: Mohammad Sadegh
authors.initials: MS
authors.lastname: Aboutalebi
authors.affiliation: Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran. Electronic address: Sadat_z2003@yahoo.com.
authors.forename: Zohreh
authors.initials: Z
authors.lastname: Sadat
mesh_terms: D000082:Acetaminophen / Q000494:pharmacology / Q000627:therapeutic use; D000328:Adult; D000700:Analgesics / Q000494:pharmacology / Q000627:therapeutic use; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data; D005260:Female; D005283:Fentanyl / Q000494:pharmacology / Q000627:therapeutic use; D006779:Hospitals, Public / Q000458:organization & administration; D006801:Humans; D007492:Iran; D008297:Male; D008614:Meperidine / Q000494:pharmacology / Q000627:therapeutic use; D008875:Middle Aged; D059408:Pain Management / Q000379:methods / Q000592:standards*; D010147:Pain Measurement / Q000295:instrumentation / Q000379:methods; D011446:Prospective Studies; D012044:Regression Analysis; D016019:Survival Analysis; D013997:Time Factors; D014947:Wounds and Injuries / Q000150:complications* / Q000188:drug therapy
chemical_list: D000700:Analgesics; D000082:Acetaminophen; D008614:Meperidine; D005283:Fentanyl
keywords: Emergency department; Nurse; Pain management; Trauma