Acute pain is underassessed in out-of-hospital emergencies

Acad Emerg Med. 2003 Jun;10(6):627-32. doi: 10.1111/j.1553-2712.2003.tb00046.x.

Abstract

Objectives: To evaluate the quality of pain assessment by emergency medical services (EMS) in out-of-hospital emergencies.

Methods: A prospective study was conducted on a convenience sample of patients during a one-year observation period. Pain ratings assessed by emergency patients were documented at three different intervals during the emergency call, and compared with concomitant assessments by EMS providers. A visual analog scale (VAS) and a verbal pain scale (VPS) were used for pain assessment. Repeated-measures ANOVA and Dunnett's t-test were used for data analysis.

Results: Fifty-one out of 70 eligible patients met inclusion criteria. In most emergency patients the intensity of pain was underestimated by EMS, especially when pain was severe (p = 0.0001). During the course of transport, both pain and pain assessment by EMS improved significantly (p = 0.0001). The VAS and VPS were significantly correlated (p = 0.0001).

Conclusions: EMS providers significantly underestimate their patients' pain severity. EMS providers should be more attentive to their patients' complaints and comfort.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Austria
  • Clinical Competence / statistics & numerical data
  • Cohort Studies
  • Emergency Medical Services / standards*
  • Emergency Medical Services / statistics & numerical data
  • Emergency Medical Technicians / statistics & numerical data
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain / classification
  • Pain Measurement / standards*
  • Pain Measurement / statistics & numerical data
  • Physicians / statistics & numerical data
  • Prospective Studies
  • Quality of Health Care / statistics & numerical data*
  • Time
  • Transportation of Patients / statistics & numerical data