Original ContributionsPatient preferences regarding pain medication in the ED☆,☆☆,★,★★
Section snippets
Methods
A convenience sample was taken from all patients with long-bone fractures presenting to the ED of St. Joseph Mercy Hospital, a 550-bed community teaching hospital with a Level II Trauma Center located in Ann Arbor, Michigan. The ED has an annual census of 64,000 and is staffed by emergency medicine faculty as well as residents in emergency medicine, internal medicine and transitional (rotating internship) training programs. The study took place over a 15-month period between July 1997 and
Results
One hundred-nine patients were approached for enrollment on the study. One patient refused participation and one was excluded because of incomplete data, leaving 107 patients in the final study sample. The mean age was 57 years (range 18 to 94 years) and 41% were 65 years of age or older. Sixty-five percent of the subjects were women, 85% were Caucasian and 14% were African American. In terms of fracture location, 42% of the subjects had fractures of the radius or ulna (including wrist), 30%
Discussion
We found that 88% (94/107) of our patients with acute long-bone fractures wanted pain medication given in the ED. This group had an initial pain level of 69 mm on a 100-mm visual analog scale. In contrast, 12% of our study patients, with an initial pain level of 29 mm, declined pain treatment in the ED. The difference between these two groups in initial pain levels was statistically significant.
These results suggest that most, but not all, patients with long-bone fractures want pain medication
Conclusion
Alleviating pain and suffering is a traditional goal of medical care. Past studies have shown that a large number of ED patients with extremity fractures are not treated for pain. We found that 88% of the patients who presented with acute long-bone fractures wanted pain medication given in the ED, and 77% actually were treated for their pain. Almost 7 out of 10 were willing to accept pain medication given by the ED nurse before the physician evaluation. In addition, patients preferred the
Acknowledgements
The authors wish to acknowledge the statistical and editorial assistance of Brenda Gillespie, PhD, of the University of Michigan Center for Statistical Consultation and Research.
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Cited by (38)
Patient Pain Experiences and the Emergency Department Encounter: A Qualitative Analysis
2022, Pain Management NursingEmergency Nurse Perceptions of Pain and Opioids in the Emergency Department
2021, Pain Management NursingCitation Excerpt :Since ED opioid prescriptions are typically prescribed for short time frames (Jeffery et al., 2018), they alone may not be enough to cause OUD. Complicating matters further, patients frequently report inadequate pain control for acute injuries in the ED (Beel et al., 2000; Tanabe & Buschmann, 1999; Todd et al., 2007). Unrelieved pain is also an epidemic with important health consequences (Blomqvist, 2003; Schwaller & Fitzgerald, 2014).
Older Adult Emergency Department Pain Management Strategies
2018, Clinics in Geriatric MedicineCitation Excerpt :Gueant and colleagues51 identified reasons for inadequate analgesia and measures to improve quality of ED pain management. Patient surveys report 23 minutes as a reasonable time to wait for ED pain medication, yet studies demonstrate an average wait time of 2.3 hours.52 Guidelines (see previous discussion) list goals that ED providers should attain in the care of elders with pain.
Patient Perspectives of Acute Pain Management in the Era of the Opioid Epidemic
2015, Annals of Emergency MedicineCitation Excerpt :The prevalence of pain as the presenting complaint in emergency departments (EDs) ranges between 38% and 78%.3-5 Up to 70% of patients with acute pain fail to receive any analgesics in the ED.6-9 Previously noted barriers to adequate pain management included provider failure to acknowledge pain, failure to document pain, inadequate training on analgesia, and sociodemographic biases.10
Acute Pain Management in Older Adults in the Emergency Department
2013, Clinics in Geriatric MedicineLevel of pain and waiting time in the emergency department
2010, Pain Management Nursing
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Returned July 13, 1999.
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Address reprint requests to Todd L. Beel, MD, Department of Emergency Medicine, St. Joseph Mercy Hospital, PO Box 995, Ann Arbor, MI, 48106-0995. Email: [email protected]
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Am J Emerg Med 2000;18:376-380.
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0735-6757/00/1804-0004$10.00/0