Management of pain in a surgical emergency unit—Underlying factors affecting its delivery

Abstract

Background

Pain is an important symptom in emergency departments. The purpose of this study was to evaluate possible obstacles to pain management in a surgical emergency department.

Methods

All patients arriving in the ED (N = 100) during the time period were asked to participate in an interview. Information about medication, patient history, and documented pain intensity were extracted from patient records. In addition, a questionnaire with six demographic and 31 pain-related items was distributed to 50 physicians and 82 nurses.

Results

Pain was the most important symptom of 60.3% (N = 46) of the respondents. Severe pain was reported by 45.8% of the patients. Analgesics were administered to 46.6% of the respondents (N = 34). None of the patients received nonsteroidal anti-inflammatoric analgesics (NSAIDs). Male gender, lower educational level and high age correlated with reluctance to accept analgesics. Experience of pain and the healthcare system correlated with unwillingness to talk about pain. The nurses were more positive towards measurement of pain (p < 0.05) and encouragement (p < 0.001) than the physicians. The physicians were less concerned about problems with analgesics than the nurses (p < 0.01).

Conclusion

The patients should be encouraged to talk about their pain. The emergency department personnel needs education about measurement of pain and pain medication.