scholarly journals Acute Pain Assessment Inadequacy in the Emergency Department: Patients’ Perspective

2022 ◽  
Vol 9 ◽  
pp. 237437352110496
Author(s):  
Jenni Hämäläinen ◽  
Tarja Kvist ◽  
Päivi Kankkunen
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Acute Pain ◽  
Pain Assessment ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Numerical Rating ◽  
Emergency Department Patients ◽  
Pain At Rest ◽  
Patients Perspective

For many patients, acute pain is a common cause to seek treatment in an Emergency Department (ED). An inadequate assessment could cause inappropriate pain management. The aim of this study was to describe and explain patients’ perceptions of acute pain assessment in the Emergency Department. The data were collected from ED patients (n = 114). Patients reported that nurses were asking about intensity of pain at rest, but only 52% during movement. According to the patients, the most common tools to assess acute pain were the verbal rating scale (VRS; 54% of patients), numerical rating scale (NRS; 28% of patients), and visual analogue scale (VAS; 9.7% of patients). Over twenty per cent of patients stated that ED nurses did not ask about the intensity of pain after analgesic administration. Twenty-four per cent of the patients were not pleased with nursing pain assessment in the ED. The assessment of acute pain is still inadequate in the ED. Therefore, ED nurses need to be more attentive to systematic acute pain management of patients in the ED.

scholarly journals Pain Assessment in Emergency Department of Teaching Hospital in Lalitpur

2019 ◽  
Vol 2 (3) ◽  
pp. 209-213
Author(s):  
Srijana Gauchan
Keyword(s):  
Emergency Department ◽  
Data Collection ◽  
Pain Assessment ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Medical Officer ◽  
Third Stage ◽  
Numerical Rating ◽  
Assessment Standard

Background: Proper pain assessment is directly related to proper pain management.The American pain society (APS) in 1996 instituted “the pain as the 5th vital sign”, in an effort to reduce the burden of underassessment and inadequate pain management. The objective of this study is to find out the practice of pain assessment and to make improvement. Methods: This was an observational study of pain assessment by the medical officer in emergency department (ED).Convenience sampling was done at three different shift in ED. All the data of pain assessment was taken and tabulated and analysed to know the practice of pain assessment. Standard as set at 80%. In first stage data collection was done for one month as per convenience. Following the observed finding, in the second stage intervention was done. After this in third stage re-data collection was done to see the improvement. Results: A total of 503 patients were enrolled in this study. Out of this 53% (n=265) were in first stage and 47% (n=238) in third stage of the study. In first stage of the study there was 7% (n=19) documentation of numerical rating scale (NRS) and PQRST (P-precipitating and palliating factor, Q-quality of pain, R-radiation, S-site of pain, T-timing of pain) was not documented. After intervention in third stage documentation of NRS was done in 70% (n=167) and documentation of PQRST were variable. Conclusions: The study revealed that existing practice of pain assessment in the emergency department is poor but after the intervention there was remarkable improvement in the pain assessment.

Comparing the efficacy of nebulized morphine with intravenous morphine in traumatic musculoskeletal pain management

2020 ◽  
Vol 8 (1) ◽  
pp. 21-21
Author(s):  
Mani Mofidi ◽  
Ali Dashti ◽  
Mahdi Rezai ◽  
Niloufar Ghodrati ◽  
Hoorolnesa Ameli ◽  
...  
Keyword(s):  
Pain Management ◽  
Pain Relief ◽  
Musculoskeletal Pain ◽  
Normal Saline ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Vital Signs ◽  
Categorical Variables ◽  
Intravenous Morphine ◽  
Numerical Rating

Introduction: This study was designed to compare the effectiveness of intravenous morphine with nebulized morphine in pain relief of patients referring to the emergency setting with traumatic musculoskeletal pain. Methods: This randomized, placebo-controlled and double-blind clinical study evaluated 160 patients 18 to 65 years of age with acute traumatic pain, who attended the emergency department during 2019. Subjects were assessed with Numerical Rating Scale based on inclusion and exclusion criteria and randomly divided into two groups. In one group, 80 patients received IV morphine (0.1 mg/kg+5 mL normal saline) plus an equivalent volume of IV placebo. In the second group, 80 patients received nebulized morphine (0.2 mg/kg+5 mL normal saline) plus nebulized placebo. Pain score was monitored in all patients with Numerical Rating Scale before and after intervention at baseline, 15, 30, 45, and 60-minute intervals. Patients’ vital signs and possible adverse events were evaluated in each observation time points. Finally, all participants were assessed for their satisfaction with pain management. Data were analyzed using repeated measure analysis for continuous variables and Binomial test for categorical variables Results: There was no significant difference between the demographic characteristics of patients in study groups. Pain relief between the two groups was similar during the observation (0, 15, 30, 45, 60 min) (P>0.05). There were no changes in vital signs between two groups, although the nebulized group had lower systolic blood pressure at the time-point of 15 minutes after the treatment initiation (P=0.03). Conclusion: Although Nebulized morphine has similar efficacy in comparison with IV route, nebulization might be considered as the clinically efficacious route of morphine administration with minimal side effects, providing optimal pain relief in patients.

scholarly journals Individual Differences and Similarities in the Judgement of Facial Pain: A Mixed Method Study

2020 ◽  
Vol 10 (4) ◽  
pp. 1186-1194
Author(s):  
Sheila Glenn ◽  
Helen Poole ◽  
Paula Oulton
Keyword(s):  
Individual Differences ◽  
Undergraduate Students ◽  
Pain Assessment ◽  
Health Care Professionals ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Pain Catastrophizing ◽  
Sensory Sensitivity ◽  
Facial Cues ◽  
Numerical Rating

Accurate assessment of pain by health-care professionals is essential to ensure optimal management of pain. An under-researched area is whether personality characteristics affect perception of pain in others. The aims were (a) to determine whether individual differences are associated with participants’ ability to assess pain, and (b) to determine facial cues used in the assessment of pain. One hundred and twenty-eight undergraduate students participated. They completed questionnaire assessments of empathy, pain catastrophizing, sensory sensitivity and emotional intelligence. They then viewed and rated four adult facial images (no, medium, and high pain—12 images total) using a 0–10 numerical rating scale, and noted the reasons for their ratings. (a) Empathy was the only characteristic associated with accuracy of pain assessment. (b) Descriptions of eyes and mouth, and eyes alone were most commonly associated with assessment accuracy. This was the case despite variations in the expression of pain in the four faces. Future studies could evaluate the effect on accuracy of pain assessment of (a) training empathic skills for pain assessment, and (b) emphasizing attention to the eyes, and eyes and mouth.

Evaluation of pain management in medical transfer of trauma patients by air

CJEM ◽  
2019 ◽  
Vol 21 (6) ◽  
pp. 776-783
Author(s):  
Isabelle H. Miles ◽  
Russell D. MacDonald ◽  
Sean W. Moore ◽  
James Ducharme ◽  
Christian Vaillancourt
Keyword(s):  
Pain Management ◽  
Adverse Events ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Trauma Centre ◽  
Air Transport ◽  
Future Research ◽  
Trauma Patients ◽  
Numerical Rating ◽  
Standard Deviation Range

ABSTRACTObjectivesWith regionalized trauma care, medical transport times can be prolonged, requiring paramedics to manage patient care and symptoms. Our objective was to evaluate pain management during air transport of trauma patients.MethodsWe conducted a 12-month review of electronic paramedic records from a provincial critical care transport agency. Patients were included if they were ≥18 years old and underwent air transport to a trauma centre, and excluded if they were Glasgow Coma Scale score <14, intubated, or accompanied by a physician or nurse. Demographics, injury description, and transportation parameters were recorded. Outcomes included pain assessment via 11-point numerical rating scale, patterns of analgesia administration, and analgesia-related adverse events. Results were reported as mean ± standard deviation, [range], (percentage).ResultsWe included 372 patients: 47.0 years old; 262 males; 361 blunt injuries. Transport duration was 82.4 ± 46.3 minutes. In 232 (62.4%) patients who received analgesia, baseline numerical rating scale was 5.9 ± 2.5. Fentanyl was most commonly administered at 44.3 [25–60] mcg. Numerical rating scale after first analgesia dose decreased by 1.1 [-2–7]. Thereafter, 171 (73.7%) patients received 2.4 [1-18] additional doses. While 44 (23.4%) patients had no change in numerical rating scale after first analgesia dose, subsequent doses resulted in no change in numerical rating scale in over 65% of patients. There were 43 adverse events recorded, with nausea the most commonly reported (39.5%).ConclusionsInitial and subsequent dose(s) of analgesic had minimal effect on pain as assessed via numerical rating scale, likely due in part to inadequate dosing. Future research is required to determine and address the barriers to proper analgesia.

scholarly journals Prospective analysis of post-operative pain management in elective laparotomies in a tertiary care centre

2021 ◽  
Author(s):  
Nithya T. ◽  
S. Rajagopalan
Keyword(s):  
Pain Management ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Open Cholecystectomy ◽  
Care Center ◽  
Tertiary Care ◽  
Open Appendectomy ◽  
Tertiary Care Centre ◽  
Numerical Rating ◽  
Management Method

Background: The study was conducted to record the drug used for postoperative pain in elective laparotomies and to determine the effectiveness of multimodal analgesics used.Methods: A prospective observational study for a period of 15 months from March 2019 to May 2020 in 140 patients who underwent elective laparotomies from the department of general surgery Rajarajeswari medical college and hospital (tertiary care center).Results: A total of 140 patients were included among which 58 (41.4%) were female and 82 (58.6%) were male patients. The 20 different types of surgeries were recorded. In our study the most common surgery performed was open appendectomy followed by open cholecystectomy. Most common mode of analgesia used was combined analgesia. Opioids, NSAIDS (non-steroidal anti-inflammatory drugs), epidural and transdermal patch was used. NRS (numerical rating scale) score was recorded for all 140 patients on postoperative days 1, 2 and 3.Conclusions: Combined analgesia was better mode of pain management method than a single analgesic. Due to different multimodal analgesics used in different institutions patients experienced different degrees of pain, hence we need a standard protocol for a best pain management method.

How patients and physicians rate patients’ pain in a French emergency department using a verbally administered numerical rating scale and a visual analog scale

Acute Pain ◽  
2008 ◽  
Vol 10 (1) ◽  
pp. 31-37 ◽  
Author(s):  
Laetitia Marquié ◽  
Liliana Rico Duarte ◽  
Claudette Mariné ◽  
Dominique Lauque ◽  
Paul Clay Sorum
Keyword(s):  
Emergency Department ◽  
Visual Analog Scale ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Analog Scale ◽  
Numerical Rating

scholarly journals A PROSPECTIVE SURVEY OF APPROPRIATENESS OF PAIN PHARMACOTHERAPY MANAGEMENT IN POST-CESAREAN SECTION PATIENTS IN CIPTO MANGUNKUSUMO HOSPITAL

2019 ◽  
pp. 280-283 ◽  
Author(s):  
JOHAN ◽  
INSTIATY ◽  
NAFRIALDI ◽  
YUDITIYA PURWOSUNU
Keyword(s):  
Pain Management ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Pain Management Index ◽  
Post Surgery ◽  
Emergency Cesarean ◽  
Experienced Pain ◽  
Chi Squared ◽  
Numerical Rating ◽  
Numerical Rating Scale Score

Objective: In this study, we sought to assess the pattern of analgesic usage, adequacy of pain management, side effects, and analgesic drug interactionsin the post-emergency cesarean surgery setting.Methods: This was a prospective observational study of 80 patients who underwent emergency cesarean surgery at the Obstetrics and GynecologyDepartment of the Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSUPN-CM) between July 2015 and January 2016. Adequacy of painmanagement during the first 3 post-operative days was assessed using Pain Management Index. Relation between pain intensity during activities andrest with patient characteristic was assessed using Chi-squared test and Fischer’s exact test.Results: Nineteen patients (8.7%) were prescribed two types of nonsteroid anti-inflammatory drugs concomitantly, and 41.8% received inappropriateanalgesics at a lower frequency. Most patients experienced pain with numerical rating scale score >3 in the first 24 h post-surgery: 59 patients(73.75%) experienced pain during activities and 7 patients (8.75%) during rest.Conclusion: Post-emergency cesarean surgery pain management at RSUPN-CM was not optimal. Most patients did not receive adequate painmanagement in the first 24 h post-surgery.

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