Parker Romy, Bedwell Gill J, Hodkinson Peter, Lourens Andrit, Setshedi Mashiko
Dept of Anaesthesia and Perioperative Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
Division of Emergency Medicine, Dept of Surgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Afr J Emerg Med. 2021 Dec;11(4):483-486. doi: 10.1016/j.afjem.2021.06.006. Epub 2021 Nov 11.
Pain is one of the most common reasons people present to the emergency centre with 7-10% of presentations being due to acute abdominal pain. However, pain is also often neglected by clinicians in emergency centres. The well validated South African Triage Score (SATS) incorporates pain assessment in the prioritising of patients with the aim of guiding clinicians. Based on the SATS, severe pain (a score of ≥8 out of 10) should prompt the clinician to initiate treatment within 10 min of presentation, as unmanaged pain has multiple negative consequences, including poor outcomes of the acute incident with delayed healing and increased risk of developing chronic pain. In this commentary, we present a patient's experience when attending an emergency centre for acute abdominal pain, describe relevant pain mechanisms and highlight the stages where clinical management could have been optimised.
疼痛是人们前往急诊中心就诊的最常见原因之一,7%至10%的就诊病例是由急性腹痛引起的。然而,急诊中心的临床医生也常常忽视疼痛问题。经过充分验证的南非分诊评分系统(SATS)在对患者进行优先级排序时纳入了疼痛评估,旨在为临床医生提供指导。根据SATS,重度疼痛(评分≥8分)应促使临床医生在患者就诊后10分钟内开始治疗,因为未得到妥善处理的疼痛会产生多种负面后果,包括急性事件的不良结局、愈合延迟以及发展为慢性疼痛的风险增加。在本评论中,我们呈现了一名患者因急性腹痛前往急诊中心就诊的经历,描述了相关的疼痛机制,并强调了临床管理本可得到优化的阶段。