Objective:The underuse of analgesics, or "oligoanalgesia," is common in emergency departments (EDs). To improve care we must understand our patients' pain experiences as well as our clinical practice patterns. To this end, we examined pain etiology, pain management practices and patient satisfaction in 2 urban EDs. Methods: We conducted a cross-sectional study using structured interviews and chart reviews for patients with pain who presented to either of 2 university-affiliated EDs. We assessed pain etiologies, patient pain experiences, pain management practices, and patient satisfaction with pain management.
Results:The 525 study subjects reported high pain intensity levels on presentation, with a median rating of 8 on a 10-point numerical rating scale (NRS). At discharge, pain severity had decreased to a median rating of 4; however, 48% of patients were discharged from the ED in moderate to severe pain (NRS 5-10). Subjects reported spending 57% of their ED stay in moderate to severe pain. Analgesics were administered to only 50% of patients. The mean time to analgesic administration was almost 2 hours. Despite high levels of reported pain at discharge and low rates of analgesic administration, subjects reported high satisfaction with pain management. Conclusions: In the 2 EDs studied, we found high levels of pain severity for our patients, as well as low levels of analgesic use. When used, analgesic administration was often delayed. Despite these findings, patient satisfaction remained high. Despite recent efforts to improve pain management practice; oligoanalgesia remains a problem for our specialty.
RÉSUMÉObjectif : La sous-utilisation des analgésiques ou «oligoanalgésie» est courante au département d'urgence (DU). Pour améliorer les soins, nous devons comprendre le niveau de douleur ressentie par nos patients ainsi que nos habitudes de pratique clinique. À cette fin, nous avons examiné l'é-tiologie de la douleur, les pratiques de prise en charge de la douleur et le degré de satisfaction des patients dans deux DU en milieu urbain. Méthodes : Nous avons mené une enquête transversale à l'aide d'entrevues structurées et de revue de dossiers pour des patients en douleur reçus à l'un ou l'autre de deux DU affiliés à une université. Nous avons évalué l'étiologie de la douleur, le niveau de douleur ressentie par les patients, les pratiques de prise en charge de la douleur et la satisfaction des patients face à cette prise en charge.