The verbal numeric pain scale: Emergency Department patients' understanding and perspectives

Author(s):  
Catherine A. Marco ◽  
Brian Patrick Murray ◽  
Mitchell McMurray ◽  
Blake Nelson ◽  
Declan Feery ◽  
...  
Author(s):  
Catherine A. Marco ◽  
Megan McGervey ◽  
Joan Gekonde ◽  
Caitlin Martin

Introduction: Pain has been identified as the most common reason for Emergency Department (ED) visits. The verbal numeric rating pain scale (VNRS) is commonly used to assess pain in the ED. This study was undertaken to determine whether VNRS pain scores correlate with desire for pain medication among ED patients. Methods: In this prospective survey study, eligible patients included Emergency Department patients over 18 with painful conditions.  The primary outcome measures included self-reported VNRS, ED diagnosis, number of ED visits and number of ED admissions within the past year, and the self-reported desire for pain medication. Results: Among 482 participants in 2012, the median triage pain score was 8 (IQR 6-10); the most frequently occurring score was 10. Overall, there were significant differences in pain scores with patient desire for analgesics. 67% reported desire for pain medications. Patients who did not want pain medications had significantly lower pain scores (median 6; IQR 4-8) compared to those who wanted medication (median 8; IQR 7-10) (p<0.001) and compared to those who were ambivalent about medication (median 7; IQR 6-10) (p=0.01). There was no association between desire for pain medication and demographics including age, gender, race, or insurance status. Conclusions: ED patients who did not desire pain medication had significantly lower pain scores than patients who desired pain medication. Pain scores usually effectively predicted which patients desired pain medications.  Desire for pain medication was not associated with age, gender, race, or insurance status. 


2020 ◽  
Author(s):  
Ahmad Wazzan ◽  
Yazeed Khalid Albeladi ◽  
Rozan Ibrahim Altaifi ◽  
Mohammed Saeed Alqahtani ◽  
Rayan Mahmoud Bakheet

Abstract Background:In the emergency department (ED), pain is the most common complaint, especially among trauma patients. However, two-thirds of trauma patients are discharged from EDs with moderate to severe pain. Therefore, pain management is an important part of care in ED's trauma patients.Aim:To assess the effectiveness of pain management among trauma patients in the ED.Method:A retrospective cohort study that was conducted on adult trauma patients who attended the ED at King Abdulaziz medical city (KAMC) in Jeddah from the period (June 2016 to July 2018). The pain was measured twice, one before the intervention and one after intervention using a numeric pain scale. Data were collected from health information system (Best care®) and analyzed using SPSS version 24.Results:The Mean difference between pain scores before and after pain management was one on a numeric pain scale with a P-Value 0.001. Initial pain assessment occurred only in 69% of our population, while assessment after intervention happened in 71% of patients. Patients who received appropriate medication were 36.7%. 35% of patients received opioids as an initial drug of pain management; only 8.8% of patients had pain scores more than 7 initially. The median between the time of arrival and the time of Initial Assessment is 19 mins.Conclusion:Pain management in ED needs improvement. Timeliness of pain management should be addressed. Evaluation and re-evaluation of pain before and after the intervention is insufficient. Trauma Patients don't receive effective pain management in the ED.


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