"ERs Physicians Give Short Shrift to Out-of-Control Pain"

From MedPage Today:

Patients who go to emergency rooms for out-of-control pain perceive that the treatment they are offered lacks dignity, satisfaction, and effectiveness.

That became evident on the basis of a series of studied reported at the American Pain Society meeting here. The papers described the frustration and dissatisfaction and patients. Instead of obtaining relief, they are rebuffed, disbelieved, or made to wait hours to see a doctor and are sometimes sent away without treatment.

"Much remains to be done in this area," said Knox Todd, M.D., director of the Pain and Emergency Medicine Institute at Beth Israel Medical Center in New York.

He found in a study that included 842 patients arriving at ERs in hospitals across the United States and Canada that:

Patients with pain often have pain score in the moderate to intense levels when presenting to the emergency department—yet it is uncommon that the clinical staff will reassess those pain levels during the hospital stay.

Of the 842 patients, medical records note a pain assessment in 83% of cases—but a second pain assessment occurred in only 31% of cases and just 14% had three assessments.

Analgesics are underutilized. Only 61% of the patients who were surveyed by emergency room personnel—doctors or nurses who contacted the patients to record their experiences—were given analgesics.

Delays to treatment are common. The mean ER wait was 90 minutes.