Pain prevalence and pain relief in trauma patients in the Accident & Emergency department

Abstract

Background: Acute pain in the A&E department (ED) has been described as a problem, however insight into the problem for trauma patients is lacking.

Objective: This study describes the prevalence of pain, the pain intensity and the effect of conventional pain treatment in trauma patients in the ED.

Methods: In a prospective cohort study of 450 trauma patients, pain was measured on admission and at discharge, using standardized and validated pain instruments.

Results: The prevalence of pain was high, both on admission (91%) and at discharge (86%). Two thirds of the trauma patients reported moderate or severe pain at discharge. Few patients received pharmacological or non-pharmacological pain relieving treatment during their stay in the ED. Pain decreased in 37% of the patients, did not change at all in 46%, or had increased in 17% of the patients at discharge from the ED. The most effective pain treatment given was a combination of injury treatment and supplementary pharmacological interventions, however this treatment was given to a small group of patients.

Conclusions: Acute pain in trauma patients is a significant problem in the ED's. Pain itself does not seem to be treated systematically and sufficiently, anywhere in the cycle of injury treatment in the ED.