One-week survey of pain intensity on admission to and discharge from the emergency department: a pilot study

Abstract

The purpose of this pilot study was to determine the incidence and severity of pain intensity in patients 4 years of age and older presenting to the noncritical ward of the emergency department (ED). All patients presenting to the ED of two university hospitals (one general, one pediatric) who were triaged to the noncritical ward during 12 h/day for 1 week were asked to report their pain intensity on admission and again asked just prior to discharge home. The chromatic analogue scale with a range of 0-10 was used as the measure of pain intensity. Pain reports were obtained from half of all patients (58% of adults, 47% of children) admitted during the study week. Approximately one-third (29% of adults and 31% of children) reported no pain on admission, but half of both age groups (52% of adults, 48% of children) reported pain 4/10 or higher. On discharge, one-third of both groups reported pain 4/10 or higher. Eleven percent of both adults and children reported pain 1.5/10 or higher on discharge than on admission. Adult patients with musculoskeletal complaints had the highest pain intensities (mean score admission-discharge, 5.6-4.7/10; other categories, <5). For children, neurological complaints, exclusively headaches, were highest (mean score admission-discharge, 4.8-5.2/10; other categories, <5). Children accompanied by their mothers alone had poorer pain improvement (no change) than children accompanied by their fathers alone or both parents (score improvement of 1). It thus appears that pain is a problem for the majority of patients presenting to the ED. An important percentage of patients leave the ED with more pain than when they arrived. Further investigation is warranted to determine factors predicting poor pain resolution during an ED visit.