Geriatric Patients May Not Experience Increased Risk of Oligoanalgesia in the Emergency Department

Çınar, Orhan; Ernst, Ryan; Fosnocht, David E.; Carey, Jessica; Rogers, LeGrand; Carey, Adrienne; Horne, Benjamin D.; Madsen, Troy

doi:10.1016/j.annemergmed.2012.05.033

Cited by 20 publications

(13 citation statements)

References 16 publications

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“…Our finding that patients aged 56 years or more were less likely to receive NIA or early analgesia is of concern as this may indicate a lower quality of pain management. Others have also reported that older patients wait longer for analgesia 9 21. Cinar et al 9 also reported longer waiting times for analgesia among the elderly although this association was not significant after adjusting for initial pain scores.…”

Section: Discussionmentioning

confidence: 99%

“…Others have also reported that older patients wait longer for analgesia 9 21. Cinar et al 9 also reported longer waiting times for analgesia among the elderly although this association was not significant after adjusting for initial pain scores. We did adjust for Triage Pain Score and other confounding variables and the negative association between age and early analgesia remained.…”

Section: Discussionmentioning

confidence: 99%

“…Despite these initiatives, there are recent reports that considerable proportions of patients do not receive analgesia in the ED 9. For patients who do receive analgesia, it is often administered well after presentation to the ED 4 9 10.…”

Section: Introductionmentioning

confidence: 99%

“…For patients who do receive analgesia, it is often administered well after presentation to the ED 4 9 10. Timely analgesia is a responsibility of ED staff and is expected by ED patients within 30 min 4 11.…”

Section: Introductionmentioning

confidence: 99%

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Variables associated with administration of analgesia, nurse-initiated analgesia and early analgesia in the emergency department

et al. 2016

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Objective To determine the patient and clinical variables associated with administration of any analgesia, nurse-initiated analgesia (NIA, prescribed and administered by a nurse) and early analgesia (within 30 min of presentation). Methods We undertook a retrospective cohort study of patients who presented to a metropolitan ED in Melbourne, Australia, during July and August, 2013. The ED has an established NIA programme. Patients were included if they were aged 18 years or more and presented with a painful complaint. The study sample was randomly selected from a list of all eligible patients. Data were extracted electronically from the ED records and by explicit extraction from the medical record. Logistic regression models were constructed to assess associations with the three binary study end points. Results 1289 patients were enrolled. Patients were less likely to receive any analgesia if they presented 08:00-15:59 hours (OR 0.67, 95% CI 0.46 to 0.98) or 16:00-24:00 hours (OR 0.55, 95% CI 0.37 to 0.80) were triage category 5 (OR 0.20, 95% CI 0.08 to 0.49) or required an interpreter (OR 0.34, 95% CI 0.14 to 0.86). Patients were less likely to receive NIA or early analgesia if they were aged 56 years or more (OR 0.70 and 0.63; OR 0.57 and 0.21, respectively) or if they had received ambulance analgesia (OR 0.59, 95% CI 0.36 to 0.95; OR 0.38, 95% CI 0.20 to 0.74, respectively). Conclusions Patients who present during the daytime, have a triage category of 5 or require an interpreter are less likely to receive analgesia. Older patients and those who received ambulance analgesia are less likely to receive NIA or early analgesia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Variables associated with administration of analgesia, nurse-initiated analgesia and early analgesia in the emergency department

et al. 2016

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“…Pediatric patients and geriatric patients have little in common physiologically, but they share a propensity towards undermedication for pain [19,[72][73][74][75][76][77]. There is some evidence that the undertreatment of pain in those at the extremes of age is improving [78], but the rule for acute care clinicians should be to pay particular attention to pain assessment and care in these patients.…”

Section: Pay Special Attention To Pain Care At the Extremes Ofmentioning

confidence: 99%

Management of Pain in the Emergency Department

Thomas

2013

ISRN Emergency Medicine

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Since pain is a primary impetus for patient presentation to the Emergency Department (ED), its treatment should be a priority for acute care providers. Historically, the ED has been marked by shortcomings in both the evaluation and amelioration of pain. Over the past decade, improvements in the science of pain assessment and management have combined to facilitate care improvements in the ED. The purpose of this review is to address selected topics within the realm of ED pain management. Commencing with general principles and definitions, the review continues with an assessment of areas of controversy and advancing knowledge in acute pain care. Some barriers to optimal pain care are discussed, and potential mechanisms to overcome these barriers are offered. While the review is not intended as a resource for specific pain conditions or drug information, selected agents and approaches are mentioned with respect to evolving evidence and areas for future research.

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Acute Pain Management in Older Adults

Lin

Siegler

2018

Effective Treatments for Pain in the Older Patient

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Geriatric Patients May Not Experience Increased Risk of Oligoanalgesia in the Emergency Department

Cited by 20 publications

References 16 publications

Variables associated with administration of analgesia, nurse-initiated analgesia and early analgesia in the emergency department

Variables associated with administration of analgesia, nurse-initiated analgesia and early analgesia in the emergency department

Management of Pain in the Emergency Department

Acute Pain Management in Older Adults

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