Analgesic usage and reasons for emergency department attendance in ambulatory care patients with minor injury.

OBJECTIVE

The aim of the present study was to determine the reasons for which patients with minor injury attend the ED, comparing those who have and have not self-administered analgesia. Secondary outcomes were to quantify the proportion of patients who present without having taken analgesia, to describe the reasons why analgesia was not taken, and to compare pain scores between the two groups.

METHODS

Prospective observational study of adult patients with minor injury presenting to the Emergency Department of Palmerston North Hospital, Palmerston North, New Zealand. Participants answered a questionnaire about their analgesic usage and reasons for ED attendance.

RESULTS

Four hundred and seventy-three patients were enrolled, of which 63.9% had not self-administered analgesia. The most common primary reasons for ED attendance were for diagnosis (49.6%), and for treatment (31.3%). Patients who had not self-administered analgesia were significantly less likely to be seeking analgesia than those who had (22.8% vs 39.2% [P < 0.001]). They were also less likely to want an X-ray (31.8% vs 46.8% [P= 0.001]) and had a significantly lower pain score than those who had taken analgesia (47.2 vs 59.8, [P < 0.001]). They were significantly more likely to have come primarily for treatment (35.8% vs 23.1% [P= 0.017]). The most commonly cited reasons for not taking analgesia were 'didn't have any handy' (31.0%), or 'didn't have time' (27.4%).

CONCLUSION

The majority of patients who attend ED with minor injury have not taken analgesia. They come primarily for diagnosis and treatment, and often believe that their condition is too urgent to stay at home and take analgesia. Pain is usually not their main concern.