Acute pain management in the emergency department

Kelly, Anne‐Maree; Gunn, Barry

doi:10.1201/b13460-20

“…12 Similar studies emphasize that when nursing staff undertook the granting of analgesics, based on protocols, resulted in a remarkable reduction in mean time to first analgesia at 26 minutes and reduction in pain intensity. 13,14 The study of Jennings et al reports mean time to the assessment of 33.5 minutes, with 45.3% of patients being evaluated within 30 minutes of their approach. The mean time to analgesia was 60.5 min and 26.6% of patients received analgesia within 30 min of admission.…”

Section: Discussionmentioning

confidence: 99%

Musculoskeletal pain management in the emergency department

Seremeti

¹

,

Vasilopoulos

²

,

Toylia

³

et al. 2020

Preprint

0

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Introduction: The intensity of acute musculoskeletal pain is underestimated by health providers. Analgesia in adults that receive treatment for acute musculoskeletal pain varies from 11-29%. The timely and effective treatment of pain should become priority for the adequate pain management.Aim: The aim of the present study was to explore musculoskeletal pain management in the emergency department (ED).Material and Method: This is a descriptive study. The studied sample consisted of 82 patients, who admitted in the ED of Athen’s general hospital, due to acute musculoskeletal pain. For data collection, a special designed registration form was used. Related measurements were completed at two time points; the first time point was during patients’ admission to ED and the second one, 30 minutes post treatment or post ED discharge.Results: Patients average pain score was 7.25 ± 1.85 (first time point) and 3.76 ± 2.66 (second time point). Analgesia was provided to 51.2% of the sample and non-invasive methods were used in 51.2%. As for the frequency of the administrated drugs, analgesics were mostly preferred (29.3%), nonsteroidal anti-inflammatory drugs (NSAIDs) at 25.6% and opioids were used only at 9.8%. The mean time to first anministrated analgesic therapy was 16.56 ± 32.89 min.Conclusions: In spite of the extensive research and international guidelines for pain management, the fulfillment of the patients’ expectations for adequate and timely relief remains a challenge. The key for successful pain management lies to further education of medical stuff.

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“…Similar studies emphasize that when nursing staff undertook the granting of analgesics, based on protocols, resulted in a remarkable reduction in mean time to first analgesia at 26 minutes and reduction in pain intensity. 13,14 The study of Jennings et al, 12 reports mean time to the assessment of 33.5 minutes, with 45.3% of patients being evaluated within 30 minutes of their approach. The mean time to analgesia was 60.5 min and 26.6% of patients received analgesia within 30 min of admission.…”

Section: Discussionmentioning

confidence: 99%

Musculoskeletal pain management in the Emergency Department

Seremeti

¹

,

Vasilopoulos

²

,

Toylia

³

et al. 2020

HealthResJ

0

View full text Add to dashboard Cite

Introduction: The intensity of acute musculoskeletal pain is underestimated by health providers. Analgesia in adults that receive treatment for acute musculoskeletal pain varies from 11-29%. The timely and effective treatment of pain should become priority for the adequate pain management.Aim: The aim of the present study was to explore musculoskeletal pain management in the emergency department (ED).Material and Method: This is a descriptive study. The studied sample consisted of 82 patients, who admitted in the ED of Athen’s general hospital, due to acute musculoskeletal pain. For data collection, a special designed registration form was used. Related measurements were completed at two time points; the first time point was during patients’ admission to ED and the second one, 30 minutes post treatment or post ED discharge.Results: Patients average pain score was 7.25 ± 1.85 (first time point) and 3.76 ± 2.66 (second time point). Analgesia was provided to 51.2% of the sample and non-invasive methods were used in 51.2%. As for the frequency of the administrated drugs, analgesics were mostly preferred (29.3%), nonsteroidal anti-inflammatory drugs (NSAIDs) at 25.6% and opioids were used only at 9.8%. The mean time to first anministrated analgesic therapy was 16.56 ± 32.89 min.Conclusions: In spite of the extensive research and international guidelines for pain management, the fulfillment of the patients’ expectations for adequate and timely relief remains a challenge. The key for successful pain management lies to further education of medical stuff.

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“…509 records were analyzed through title and abstract screening and 495 records were excluded, with a total of 14 records remaining for full text screening [26][27][28][29][30][31][32][33][34][35][36][37][38]. Additional 336 papers were retrieved by citation tracking, of which 11 full-text records were assessed [9,29,[39][40][41][42][43][44][45][46][47]. None of the studies met the criteria for the primary outcome.…”

Section: Study Selectionmentioning

confidence: 99%

Multidimensional versus unidimensional pain scales for the assessment of analgesic requirement in the emergency department: a systematic review

Crisman,

Appenzeller-Herzog,

Tabakovic

et al. 2024

Intern Emerg Med

1

0

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Pain is a multidimensional experience, potentially rendering unidimensional pain scales inappropriate for assessment. Prior research highlighted their inadequacy as reliable indicators of analgesic requirement. This systematic review aimed to compare multidimensional with unidimensional pain scales in assessing analgesic requirements in the emergency department (ED). Embase, Medline, CINAHL, and PubMed Central were searched to identify ED studies utilizing both unidimensional and multidimensional pain scales. Primary outcome was desire for analgesia. Secondary outcomes were amount of administered analgesia and patient satisfaction. Two independent reviewers screened, assessed quality, and extracted data of eligible studies. We assessed risk of bias with the ROBINS-I tool and provide a descriptive summary. Out of 845 publications, none met primary outcome criteria. Three studies analyzed secondary outcomes. One study compared the multidimensional Defense and Veterans Pain Rating Scale (DVPRS) to the unidimensional Numerical Rating Scale (NRS) for opioid administration. DVPRS identified more patients with moderate instead of severe pain compared to the NRS. Therefore, the DVPRS might lead to a potential reduction in opioid administration for individuals who do not require it. Two studies assessing patient satisfaction favored the short forms (SF) of the Brief Pain Inventory (BPI) and McGill Pain Questionnaire (MPQ) over the Visual Analogue Scale (VAS) and the NRS. Limited heterogenous literature suggests that in the ED, a multidimensional pain scale (DVPRS), may better discriminate moderate and severe pain compared to a unidimensional pain scale (NRS). This potentially impacts analgesia, particularly when analgesic interventions rely on pain scores. Patients might prefer multidimensional pain scales (BPI-SF, MPQ-SF) over NRS or VAS for assessing their pain experience.

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Acute pain management in the emergency department

Cited by 5 publications

References 1 publication

Musculoskeletal pain management in the emergency department

Musculoskeletal pain management in the emergency department

Musculoskeletal pain management in the Emergency Department

Multidimensional versus unidimensional pain scales for the assessment of analgesic requirement in the emergency department: a systematic review

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