A week of pain in the emergency department

Background: Pain is a common complaint in patients attending the emergency department (ED), and historically, it is under-assessed and undertreated. Previous research is heterogeneous and does not well describe pain in EDs over time. Our aim was to describe pain in a UK ED using a sample that included every adult attendance over the course of 1 week.

Methods: We retrospectively reviewed every adult attendance (N = 1872) over 1 week to the ED of a large English NHS District General Hospital. We noted the initial pain score and, if the initial score was ≥5, the final recorded pain score. We categorised attendances as 'illness' or 'injury'.

Results: In all, 62.1% of patients had a pain score recorded, of whom 50.7% had a pain score of zero. Median pain score was 6/10 in patients with pain; 58% had a second score recorded. More patients with illness than injury had a second score recorded. Most patients had an improvement in their pain; however, around one-third had no change or worse pain at the end of their ED stay.

Conclusion: We have defined the incidence, severity and change in pain in an ED over 1 week. This information will underpin the design of future studies aimed at improving patient care in this important area of emergency medicine practice.