Pain prevalence and pain relief in trauma patients in the Accident & Emergency department

Background: Acute pain in the A&E department (ED) has been described as a problem, however insight into the problem for trauma patients is lacking. Objective: This study describes the prevalence of pain, the pain intensity and the effect of conventional pain treatment in trauma patients in the ED. Methods: In a prospective cohort study of 450 trauma patients, pain was measured on admission and at discharge, using standardized and validated pain instruments. Results: The prevalence of pain was high, both on admission (91%) and at discharge (86%). Two thirds of the trauma patients reported moderate or severe pain at discharge. Few patients received pharmacological or non-pharmacological pain relieving treatment during their stay in the ED. Pain decreased in 37% of the patients, did not change at all in 46%, or had increased in 17% of the patients at discharge from the ED. The most effective pain treatment given was a combination of injury treatment and supplementary pharmacological interventions, however this treatment was given to a small group of patients. Conclusions: Acute pain in trauma patients is a significant problem in the ED's. Pain itself does not seem to be treated systematically and sufficiently, anywhere in the cycle of injury treatment in the ED. (C) 2007 Elsevier Ltd. All rights reserved.