Acute Pain Is Underassessed in Out‐of‐hospital Emergencies

Luger, Thomas J.; Lederer, Wolfgang; Gassner, Michael; Löckinger, Alexander; Ulmer, Hanno; Lorenz, Ingo

doi:10.1111/j.1553-2712.2003.tb00046.x

Cited by 41 publications

(25 citation statements)

References 19 publications

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“…Research indicates that healthcare providers – nurses in particular – are prone to underestimate the severity of patient pain compared to self-report, and that there is variability in pain ratings between and within provider types (Choiniere et al, 1990; Davoudi et al, 2008; Green et al, 2001; Green and Wheeler, 2003; Luger et al, 2003; Sloman et al, 2005). Relatively little has been published concerning the accuracy of nurses’ assessment of patient emotional status in general and in the context of pain in particular.…”

Section: Introductionmentioning

confidence: 99%

“…Patients who are female (see reviews by Kamath and O'Connor, 2011 and LeResche, 2011), racial/ethnic minority (see reviews by Kamath and O'Connor, 2011 and Mossey, 2011), and elderly (Auret and Schug, 2005; Heins et al, 2006; Horgas and Elliott, 2004; Iyer, 2010) are at increased risk for sub-optimal pain care. These factors may also play a role in the assessment of patient mood; however, this has received little empirical attention to date.…”

Section: Introductionmentioning

confidence: 99%

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Patient demographic characteristics and facial expressions influence nurses’ assessment of mood in the context of pain: A Virtual Human and lens model investigation

Hirsh

Callander

2011

International Journal of Nursing Studies

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Background Sex, race, and age disparities in pain assessment and treatment have been reported in the literature. However, less is known about how these demographic characteristics influence nurses’ assessment of the emotional experiences of patients who are in pain. Objectives To investigate the influence of patient demographic characteristics and facial expressions on nurses’ assessment of patient mood in the context of pain. Design A cross-sectional study employing Virtual Human (VH) technology and lens model methodology. Settings The current study was delivered via the internet. Participants Participants consisted of 54 registered nurses currently engaged in clinical practice. Nurses were recruited from healthcare settings across the United States. Methods Nurses viewed 32 patient vignettes consisting of a video clip of the VH patient and text-based clinical summary information describing a post-surgical context. Patient sex, race, age, and facial expression of pain were systematically manipulated across vignettes. Participants made positive and negative mood assessment ratings on computerized visual analogue scales. Idiographic multiple regression analyses were used to examine the patient characteristics that were significant predictors of nurses’ assessment ratings. Nomothetic paired samples t-tests were used to compare ratings within cue for the entire sample. Results The results of idiographic and nomothetic analyses indicated that VH sex, race, age, and facial expression cues were significant predictors of the mood assessment ratings of many nurses. The age cue had the largest impact among the demographic variables. Conclusions The results of the current study suggest that patient demographic characteristics and facial expressions may influence how nurses assess patient emotional status in the clinical pain context. These findings may lead to greater awareness by individual nurses and nursing administrators about the influence of patient demographic characteristics on clinical decision-making. Future research is needed to better understand these relationships, with the ultimate goal of improving patient care.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patient demographic characteristics and facial expressions influence nurses’ assessment of mood in the context of pain: A Virtual Human and lens model investigation

Hirsh

Callander

2011

International Journal of Nursing Studies

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“…Significant deficiencies in acute pain management in emergency medicine have been identified. Several studies reported an underestimation of pain by (emergency) physicians and nurses (Luger et al, 2003) and deficiencies in pre-hospital pain management (Abbuhl and Reed, 2003;Hennes et al, 2005;Berben et al, 2011a). Similar results are reported in the ED (Todd et al, 2007;Berben et al, 2008).…”

Section: Introductionmentioning

confidence: 66%

Review on pharmacological pain management in trauma patients in (pre‐hospital) emergency medicine in the Netherlands

Dijkstra

Berben

Dongen

et al. 2013

European Journal of Pain

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Pain is one of the main complaints of trauma patients in (pre-hospital) emergency medicine. Significant deficiencies in pain management in emergency medicine have been identified. No evidence-based protocols or guidelines have been developed so far, addressing effectiveness and safety issues, taking the specific circumstances of pain management of trauma patients in the chain of emergency care into account. The aim of this systematic review was to identify effective and safe initial pharmacological pain interventions, available in the Netherlands, for trauma patients with acute pain in the chain of emergency care. Up to December 2011, a systematic search strategy was performed with MeSH terms and free text words, using the bibliographic databases CINAHL, PubMed and Embase. Methodological quality of the articles was assessed using standardized evaluation forms. Of a total of 2328 studies, 25 relevant studies were identified. Paracetamol (both orally and intravenously) and intravenous opioids (morphine and fentanyl) proved to be effective. Non-steroidal anti-inflammatory drugs (NSAIDs) showed mixed results and are not recommended for use in pre-hospital ambulance or (helicopter) emergency medical services [(H)EMS]. These results could be used for the development of recommendations on evidence-based pharmacological pain management and an algorithm to support the provision of adequate (pre-hospital) pain management. Future studies should address analgesic effectiveness and safety of various drugs in (pre-hospital) emergency care. Furthermore, potential innovative routes of administration (e.g., intranasal opioids in adults) need further exploration.

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“…Die kli ni sche Re le vanz der vor lie genden Er geb nis se liegt da rin, dass Fehl urtei le des be han deln den Arz tes zu ei ner the ra peu ti schen Über-oder Un ter ver sorgung füh ren kön nen [8,18]. Dies ist ins beson de re bei Pa ti en ten zu er war ten, de ren Schmer zen vom Arzt nicht er kannt werden, da sie ent we der von ei ner an ge messe nen the ra peu ti schen Ver sor gung aus geschlos sen wer den oder eine Ten denz zum "doc tor shop ping" ent wi ckeln, weil sie sich von ih rem be han deln den Arzt un ver standen füh len.…”

Section: Be Wer Tung Und In Ter Pre Ta Ti On Der Er Geb Nis Seunclassified

“…Sehr häu fig werden Schmer zen des Pa ti en ten ge ra de vom me di zi ni schen Per so nal un ter schätzt [25]. Die se Ur teil ab wei chun gen sind sys te matisch: Sie tre ten un ab hän gig von der beur teil ten Pa ti en ten po pu la ti on [2,5,17,24,26] und dem ver wen de ten Ska len typ auf [14,18]. Eine Viel zahl von Fak to ren begüns tigt einen Bias des be han deln den Arztes im Sin ne ei nes "un der re por ting" von Schmer zen.…”

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Überschätzen Ärzte die Effekte der Akupunkturbehandlung?

Lungenhausen

Endres

Kukuk

et al. 2005

Schmerz

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Acute Pain Is Underassessed in Out‐of‐hospital Emergencies

Abstract: EMS providers significantly underestimate their patients' pain severity. EMS providers should be more attentive to their patients' complaints and comfort.

Cited by 41 publications

References 19 publications

Patient demographic characteristics and facial expressions influence nurses’ assessment of mood in the context of pain: A Virtual Human and lens model investigation

Patient demographic characteristics and facial expressions influence nurses’ assessment of mood in the context of pain: A Virtual Human and lens model investigation

Review on pharmacological pain management in trauma patients in (pre‐hospital) emergency medicine in the Netherlands

Überschätzen Ärzte die Effekte der Akupunkturbehandlung?

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