Dale Jostein, Bjørnsen Lars Petter
Emergency Department, Clinic of Emergency Medicine and Prehospital Care, St. Olav's Hospital, Trondheim, Norway.
Scand J Trauma Resusc Emerg Med. 2015 Oct 29;23:86. doi: 10.1186/s13049-015-0166-3.
Although pain management is a fundamental aspect of care in emergency departments (EDs), inadequate treatment of pain is unfortunately common. There are multiple local protocols for pain assessment in the ED. This study evaluated whether the initial assessment and treatment of pain in the ED are in accordance with the in-hospital protocol of the ED at a Norwegian University Hospital.
Prospective data on pain assessment and initial treatment in the ED were collected from nursing and physician documentation. The patients' perceptions of subjective pain were recorded using a numerical rating scale (NRS) that ranged from 0 to 10.
Seventy-seven percent of the 764 enrolled patients were evaluated for pain at arrival. Female patients had a higher probability of not being asked about pain, but there was no difference in the percentage of patients asked about pain with respect to age. Additionally, patients with low oxygen saturation and systolic blood pressure were less likely to be asked about pain. Of those with moderate and severe pain (58 %), only 14 % received pain relief.
Assessment and treatment of pain in the ED are inadequate and not in line with the local protocols. A focus on strategies to improve pain treatment in the ED is a necessary aspect of developing optimal acute patient care in Norway in the future.
尽管疼痛管理是急诊科护理的一个基本方面，但遗憾的是，疼痛治疗不足的情况很常见。急诊科有多种疼痛评估的本地方案。本研究评估了挪威一家大学医院急诊科对疼痛的初始评估和治疗是否符合急诊科的院内方案。
从护理和医生记录中收集急诊科疼痛评估和初始治疗的前瞻性数据。使用0至10的数字评分量表（NRS）记录患者对主观疼痛的感知。
764名登记患者中，77%在到达时接受了疼痛评估。女性患者未被询问疼痛情况的可能性更高，但就年龄而言，被询问疼痛情况的患者百分比没有差异。此外，血氧饱和度和收缩压较低的患者被询问疼痛情况的可能性较小。在中度和重度疼痛患者（58%）中，只有14%得到了疼痛缓解。
急诊科对疼痛的评估和治疗不足，不符合本地方案。关注改善急诊科疼痛治疗的策略是未来挪威发展最佳急性患者护理的一个必要方面。
