Pain in patients attended at risk classification of an emergency service

Abstract

BACKGROUND AND OBJECTIVES: Pain is a major symptom responsible for the search for urgency care. This study aimed at checking the presence of pain in patients attending the risk classification. METHODS: This is a cross-sectional and descriptive study carried out at an urgency care unit, using a form with socio-demographic and clinical data, risk classification, analgesia and pain record on medical charts. Pain Management Index proposed by the World Health Organization was calculated. RESULTS: From 102 patients included in the study, 82 (80.2%) reported pain, 45 (54.9%) were females, 48 (58.5%) were married, most (62-75.6%) lived in Greater Aracaju, 28 (34.1%) were classified as yellow. Acute, severe to moderate pain was the most frequent. In 71 (86.6%) cases, continuous pain has motivated the search for urgency care. Pain recording was present in almost all medical charts, being 80.5% performed by physicians. Simple analgesics and non-steroid anti-inflammatory drugs were the most frequently prescribed analgesics (59-72%). Pain management was inadequate in 86.6% of cases and there has been wide variation between admission and administration of first analgesia (mean: 94.5 min; min-max: 8-360 min). CONCLUSION: The lack of analgesic protocols at risk classification may impair adequate pain management.

Pain in emergency units: correlation with risk classification categories

“…Participants in this study who did not present pain were significantly older than those with moderate pain. A study carried out in an Emergency Service in Aracajú showed that patients with moderate pain complaints were younger than those who did not present pain, corroborating the results of the present study 10 . Studies show that age is a factor that may modify the experience of the patient regarding pain and the effect of aging may make them less sensitive to painful stimuli 19 .…”

“…Regarding the intensity of pain reported by the patients in this study, the majority reported no pain (37.6%), and the rest, moderate (25.9%), intense (24.4%) and mild (12.1%) pain. A similar study performed in a public hospital in Aracajú found prevalence of intense (53.7%) and moderate (36.6%) pain, concluding that pain intensity was related to the main reason for seeking emergency care 10 . Although pain is one of the main reasons for seeking emergency care and despite the existence of scales to assess its intensity, few professionals use these tools during care 7 .…”

“…Based on this complaint, resources are used to classify and organize the priorities of these patients. Pain is one of the main reasons that can generate inabilities and cause human suffering, impacts the quality of life, and can generate psychosocial and economic repercussions 10 .…”

“…A study that evaluated the knowledge of nurses about pain showed that 73.3% never participated in a training on pain assessment and that their knowledge about pain management was medium 18 . This shows the importance of nurses to develop skills to make a complete evaluation of complaints, without underestimating the patients’ pain that can often be indicative of the severity of his health condition 10 .…”

Manchester Triage System: assessment in an emergency hospital service

“…It is important to highlight the scarcity of publications that associate the priority levels of MTS with sociodemographic data. Some studies (10,18,(24)(25) described the prevalence of sex and the average age of the population studied and another (26) associated the complaint of pain in RS with sex and age.…”