NDLI: Timely pain management in the emergency department.

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Timely pain management in the emergency department.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Patrick, Patricia A. Rosenthal, Barry M. Iezzi, Carina A. Brand, Donald A.
Description	Author Affiliation: Patrick PA ( Office of Health Outcomes Research, Winthrop University Hospital, Mineola, New York); Rosenthal BM ( School of Medicine, Stony Brook University, Stony Brook, New York); Iezzi CA ( Department of Health and Nutrition Sciences, Brooklyn College, Brooklyn, New York.); Brand DA ( Office of Health Outcomes Research, Winthrop University Hospital, Mineola, New York)
Abstract	BACKGROUND: Delivering timely pain relief remains a challenge for most emergency departments. OBJECTIVE: To evaluate the effectiveness of a policy aimed at delivering analgesics within 30 min to patients presenting to an emergency department with severe pain. METHODS: Subjects were aged ≥19 years, had a principal diagnosis of renal colic, hip fracture, or sickle cell disease, reported a pain score ≥8 on a scale of 0 to 10 at triage, and continued to report a score in this range until receiving analgesia. The study compared proportions of patients receiving analgesics within the 30-min target, median time to analgesic administration, and median time to relief of severe pain (decline in pain level to score <8) during 6 months before vs. 6 months after implementation of the new pain management policy. RESULTS: Paradoxically, the median total waiting time to analgesic administration increased from 64 min (n = 75) to 80 min (n = 70) after policy implementation (p = 0.01), and the proportion of patients receiving analgesics within 30 min declined from 17% (13/75) to 7% (5/70) (p = 0.08). Median time to relief of severe pain did not differ significantly between periods (130.5 vs. 153 min; p = 0.31). CONCLUSIONS: After implementation of the new pain management policy, the proportion of patients with severe pain receiving analgesics within 30 min actually declined. Although a 30-min target may be unrealistic, it seems reasonable to conclude that something is wrong when patients with notoriously painful conditions must typically wait 1-2 h to obtain relief. Given the millions of individuals who receive care in emergency departments nationwide each year, the suffering caused by delays occurs on a large scale, so creative approaches are clearly needed to overcome the obstacles.
File Format	HTM / HTML
ISSN	07364679
Issue Number	3
Volume Number	48
Journal	The Journal of Emergency Medicine
Language	English
Publisher	Elsevier
Publisher Date	2015-03-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Emergency medicine Analgesics Therapeutic Use Emergency Service, Hospital Standards Pain Drug Therapy Time-to-treatment Adult Aged Aged, 80 And Over Administration & Dosage Anemia, Sickle Cell Complications Female Hip Fractures Humans Male Middle Aged Organizational Policy Etiology Pain Measurement Practice Guidelines As Topic Renal Colic Statistics & Numerical Data Young Adult Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine

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