Kosiński Sylweriusz, Siudut Bogusława
Oddział Anestezjologii i Intensywnej Terapii, Szpital Specjalistyczny Chorób Płuc w Zakopanem.
Anestezjol Intens Ter. 2011 Oct-Dec;43(4):234-8.
Pain on admission, especially after trauma, is the most common complaint (over 80%) of patients in the emergency department. During a four-week period, an anonymous, voluntary survey on the quality of pain management was conducted among adult patients reporting to the emergency department.
Five hundred questionnaires were distributed during admission, and 260 were returned. Patients were asked about localisation and severity of pain (NRS - Numerical Rating Scale), the quality and speed of assistance in the emergency department, and the effectiveness of analgesia.
Ninety percent of patients reported pain of varying intensity. The median pain scores on admission were 5.2, 7.3 during management, and 3.8 on discharge. Over 90% of patients were questioned about pain, but only 20% received some medication. Nevertheless, 80% of those surveyed were satisfied, and there was no correlation between the severity of pain and administration of analgesics. Fifty percent of patients received analgesics for home use, and 66% were instructed about further treatment.
Despite the frequency and intensity of pain, analgesics were rarely offered in the emergency department. A surprisingly high level of satisfaction was reported, despite suboptimal pain management. This indicates either that non-pharmacologic methods of pain treatment play an important role, or that the severity of pain is overestimated by patients.
入院时的疼痛,尤其是外伤后的疼痛,是急诊科患者最常见的主诉(超过80%)。在四周的时间里,对到急诊科就诊的成年患者进行了一项关于疼痛管理质量的匿名自愿调查。
入院时发放了500份问卷,回收260份。询问患者疼痛的部位和严重程度(数字评定量表-NRS)、急诊科的帮助质量和速度以及镇痛效果。
90%的患者报告有不同程度的疼痛。入院时疼痛评分中位数为5.2,治疗期间为7.3,出院时为3.8。超过90%的患者接受了疼痛询问,但只有20%的患者接受了某种药物治疗。然而,80%的受访者表示满意,疼痛严重程度与镇痛药的使用之间没有相关性。50%的患者接受了家用镇痛药,66%的患者得到了进一步治疗的指导。
尽管疼痛频繁且剧烈,但急诊科很少提供镇痛药。尽管疼痛管理不理想,但报告的满意度却出奇地高。这表明要么非药物疼痛治疗方法发挥了重要作用,要么患者高估了疼痛的严重程度。