Management of Acute Pain in the Emergency Department

Inadequate pain management remains a major challenge for health care providers. Despite extensive research on the mechanisms of acute pain, identification of factors leading to poor pain management and development of evidence-based strategies, the transfer of this knowledge into effective clinical practices has been surprisingly slow. Oligoanalgesia1 has been widely recognized as an issue in emergency department (ED) patients. Acute pain is reported by 60-80% of ED inpatients but is frequently undertreated. Overall, an insufficient proportion of patients with acute pain receive any type of analgesia, and pain relief remains unsatisfactory. We showed that the implementation of guidelines improved pain management. However, rotation of the medical & nursing staff leads to the forgetting of guidelines. The purpose of our study is to assess the impact of the implementation of a computer-assisted support program to improve pain management in our ED.

Inclusion criteria

Any patient admitted to our Emergency Department who is

• age > 16 years
• pain lasting =< 1 week or
• no pain on admission but pain during the ED stay

Exclusion criteria

• life-threatening condition requiring immediate admission in the OR or ICU
• no pain or pain lasting >1 week
• inability to give informed consent (intoxicated, psychiatric disorder, language problem, prisoner)