Pain management in the Emergency Department – Still a long way to go?

Pain management in the Emergency Department – Still a long way to go? In this issue of the Scandinavian Journal of Pain, Lars Sturesson and his co-workers report on patients’ experiences with pain management in the emergency department of a general hospital in Stockholm, Sweden [1]. The authors found that after the intervention, requiring mandatory documentation of patients’ pain intensities, performed by registered nurses (RNs) in the emergency department (ED), there was increased administration of analgesics by RNs, but the intervention did not affect the patients’ satisfaction with their pain management. In this hospital the RNs in the ED are able to administer non-opioid and opioid analgesic drugs according to nurse- and physician-developed guidelines.1Why did increased use of analgesic drugs not improve the patients’ reported pain intensities and satisfaction with pain management?This paradoxical finding calls for an explanation. A conventional explanation would be that the instruments used for measuring pain did not have the necessary sensitivity (resolution) and validity, thus not capturing the decrease in pain that the patients nevertheless must have experienced.Pain-intensity measurement is important, but the problem probably has deeper roots than that. If we attempt to pragmatically break down the issue of pain reporting into its constituent parts, the following components may be identified: pain signal, pain perception, and http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Scandinavian Journal of Pain de Gruyter

Pain management in the Emergency Department – Still a long way to go?

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Publisher
De Gruyter
Copyright
© 2016 Scandinavian Association for the Study of Pain
ISSN
1877-8860
eISSN
1877-8879
D.O.I.
10.1016/j.sjpain.2016.09.007
Publisher site
See Article on Publisher Site

Abstract

In this issue of the Scandinavian Journal of Pain, Lars Sturesson and his co-workers report on patients’ experiences with pain management in the emergency department of a general hospital in Stockholm, Sweden [1]. The authors found that after the intervention, requiring mandatory documentation of patients’ pain intensities, performed by registered nurses (RNs) in the emergency department (ED), there was increased administration of analgesics by RNs, but the intervention did not affect the patients’ satisfaction with their pain management. In this hospital the RNs in the ED are able to administer non-opioid and opioid analgesic drugs according to nurse- and physician-developed guidelines.1Why did increased use of analgesic drugs not improve the patients’ reported pain intensities and satisfaction with pain management?This paradoxical finding calls for an explanation. A conventional explanation would be that the instruments used for measuring pain did not have the necessary sensitivity (resolution) and validity, thus not capturing the decrease in pain that the patients nevertheless must have experienced.Pain-intensity measurement is important, but the problem probably has deeper roots than that. If we attempt to pragmatically break down the issue of pain reporting into its constituent parts, the following components may be identified: pain signal, pain perception, and

Journal

Scandinavian Journal of Painde Gruyter

Published: Dec 29, 2017

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