Pain scores among ED patients: correlation with desire for pain medication

Authors

  • Catherine A. Marco The University of Toledo Health Science Campus, Toledo, OH 43614 Wright State University, Dayton, OH 45435
  • Megan McGervey The University of Toledo Health Science Campus, Toledo, OH 43614
  • Joan Gekonde The University of Toledo Health Science Campus
  • Caitlin Martin The University of Toledo

DOI:

https://doi.org/10.46570/utjms.vol1-2014-72

Keywords:

pain, emergency, pain assessment

Abstract

Introduction: Pain has been identified as the most common reason for Emergency Department (ED) visits. The verbal numeric rating pain scale (VNRS) is commonly used to assess pain in the ED. This study was undertaken to determine whether VNRS pain scores correlate with desire for pain medication among ED patients.

Methods: In this prospective survey study, eligible patients included Emergency Department patients over 18 with painful conditions.  The primary outcome measures included self-reported VNRS, ED diagnosis, number of ED visits and number of ED admissions within the past year, and the self-reported desire for pain medication.

Results: Among 482 participants in 2012, the median triage pain score was 8 (IQR 6-10); the most frequently occurring score was 10. Overall, there were significant differences in pain scores with patient desire for analgesics. 67% reported desire for pain medications. Patients who did not want pain medications had significantly lower pain scores (median 6; IQR 4-8) compared to those who wanted medication (median 8; IQR 7-10) (p<0.001) and compared to those who were ambivalent about medication (median 7; IQR 6-10) (p=0.01). There was no association between desire for pain medication and demographics including age, gender, race, or insurance status.

Conclusions: ED patients who did not desire pain medication had significantly lower pain scores than patients who desired pain medication. Pain scores usually effectively predicted which patients desired pain medications.  Desire for pain medication was not associated with age, gender, race, or insurance status.

 

Author Biography

Catherine A. Marco, The University of Toledo Health Science Campus, Toledo, OH 43614 Wright State University, Dayton, OH 45435

Professor

Department of Emergency Medicine

References

Niska R, Bhuiya F, and Xu J. National Hospital Ambulatory Medical Care Survey: 2007 Emergency Department Summary. National health statistics reports; no 26. Hyattsville, MD: National Center for Health Statistics. 2010. DOI: https://doi.org/10.1037/e587172010-001

Institute of Medicine. Relieving pain in America: a blueprint for transforming prevention, care, education, and research. Washington, DC: The National Academies Press, 2011.

Brent ASG (2000) The management of pain in the emergency department. Pediatr Clin N Amer 47:651-679. DOI: https://doi.org/10.1016/S0031-3955(05)70231-5

Blank F, Mader T, Wolfe J, Keyes M, Kirschner R, Provost D (2001) Adequacy of pain assessment and pain relief and correlation of patient satisfaction in 68 ED fasttrack patients. Journal of Emergency Nursing 27(4):327-334. DOI: https://doi.org/10.1067/men.2001.116648

Guru V, Dubinsky I (2000) The patient vs. caregiver perception of acute pain in the emergency department. J Emerg Med18:7-12. DOI: https://doi.org/10.1016/S0736-4679(99)00153-5

Rupp T, Delaney KA (2004) Inadequate analgesia in emergency medicine. Ann Emerg Med 43:494-503.

Holdgate A, Asha S, Craig J, Thompson J (2003) Comparison of a verbal numeric rating scale with the visual analog scale for the measurement of acute pain. Emerg Med (Fremantle) 15:441-446.

Bijur PE, Latimer CT, Gallagher EJ (2003) Validation of a verbally administered numerical rating scale of acute pain for use in the emergency department. Acad Emerg Med 10:390-393. DOI: https://doi.org/10.1111/j.1553-2712.2003.tb01355.x

Daoust R, Beaulieu P, Manzini C, Chauny JM, Laviqne G (2008) Estimation of pain intensity in emergency medicine: a validation study. Pain 138:565-570. DOI: https://doi.org/10.1016/j.pain.2008.02.007

Marco CA, Plewa MC, Buderer N, Hymel G, Cooper J (2006) Selfreported pain scores in the emergency department: lack of association with vital signs. Acad Emerg Med 13:974-979. DOI: https://doi.org/10.1197/j.aem.2006.04.015

Todd KH, et al. (2007) PEMI Study Group. Pain in the emergency department: results of the pain and emergency medicine initiative (PEMI) multicenter study. J Pain 8(6):460-466. DOI: https://doi.org/10.1016/j.jpain.2006.12.005

Fosnocht DE, Swanson ER, Barton ED (2005) Changing attitudes about pain and pain control in emergency medicine. Emerg Med Clin North Am 23(2):297-306. DOI: https://doi.org/10.1016/j.emc.2004.12.003

Allione A, et al. (2011) Factors influencing desired and received analgesia in emergency department. Intern Emerg Med 6(1):69-78. DOI: https://doi.org/10.1007/s11739-010-0463-9

Miner J, Biros MH, Trainor A, Hubbard D, Beltram M (2006) Patient and Physician Perceptions as Risk Factors for Oligoanalgesia: A Prospective Observational Study of the Relief of Pain in the Emergency Department. Acad Emerg Med 13:140-146. DOI: https://doi.org/10.1197/j.aem.2005.08.008

Wilson, J, Pendleton, J (1989) Oligoanalgesia in the emergency department. Am J Emerg Med 7(6):620-623. DOI: https://doi.org/10.1016/0735-6757(89)90286-6

Silka PA, Roth MM, Moreno G, Merrill L, Geiderman JM (2004) Pain Scores improve analgesic administration patterns for trauma patients in the emergency department. Acad Emerg Med 11(3):264-270. DOI: https://doi.org/10.1111/j.1553-2712.2004.tb02207.x

Marco CA, KanitzW, Jolly M (2013) Pain Scores among Emergency Department (ED) Patients: Comparison by ED Diagnosis. J Emerg Med 44(1):46-52. DOI: https://doi.org/10.1016/j.jemermed.2012.05.002

Marco CA, Nagel J, Klink E, Baehren D (2012) Factors associated with selfreported pain scores among ED patients. Am J Emerg Med 30(2):331-237. DOI: https://doi.org/10.1016/j.ajem.2010.12.015

Holdgate A, Asha S, Craig J, Thompson J (2003) Comparison of a verbal numeric rating scale with the visual analogue scale for the measurement of acute pain. Emerg Med 15 (56): 441-446. DOI: https://doi.org/10.1046/j.1442-2026.2003.00499.x

Rupp T, Delaney KA (2004) Inadequate analgesia in emergency medicine. Ann Emerg Med 43(4):494-503. DOI: https://doi.org/10.1016/j.annemergmed.2003.11.019

Mills AM, Shofer FS, Boulis AK, Holena DN, Abbuhl SB (2011) Racial disparity in analgesic treatment for ED patients with abdominal or back pain. emAm J Emerg Med 29(7):752-756. DOI: https://doi.org/10.1016/j.ajem.2010.02.023

PlattsMills TF, et al. (2012) Older US emergency department patients are less likely to receive pain medication than younger patients: results from a national survey. Ann Emerg Med 60(2):199-206. DOI: https://doi.org/10.1016/j.annemergmed.2011.09.014

American College of Emergency Physicians (2004) Pain management in the emergency department [policy statement]. Ann Emerg Med 44:198. DOI: https://doi.org/10.1016/j.annemergmed.2004.04.003

McManus JG, Harrison B (2005) Pain and Sedation Management In the 21st Century Emergency Department. Emergency Med Clinics N America23(2): xvxvi. DOI: https://doi.org/10.1016/j.emc.2004.12.019

Downloads

Published

2014-01-23

How to Cite

Marco, C. A., McGervey, M., Gekonde, J., & Martin, C. (2014). Pain scores among ED patients: correlation with desire for pain medication. Translation: The University of Toledo Journal of Medical Sciences, 1(1), 1–4. https://doi.org/10.46570/utjms.vol1-2014-72

Issue

Section

Research Articles