Pain management in emergency departments: a descriptive study

Manejo del dolor en el servicio de urgencias

Introduction: acute pain is a medical emergency that requires immediate attention, adequate management and is an indicator of quality of care. Objective: to describe the management of acute pain by health personnel in patients attending emergency departments in hospitals and clinics in the cities of Manizales and Armenia, comparing it with protocols and guidelines for the care of this pathology approved nationally and internationally. Methods: cross-sectional observational study with descriptive scope, including patients who attended emergency department consultations in institutions in Manizales (SES Hospital Universitario de Caldas, E.S.E. Hospital Departamental Santa Sofía and Clínica San Marcel) and Armenia (Hospital Universitario San Juan de Dios and Hospital del Sur). Results: 306 patients were included, who consulted mainly for trauma (33.7%), abdominal pain (20%) and musculoskeletal or joint pain (9.4%). Pain was classified as somatic in 33.3%, visceral in 20.6% and undefined in 41.5%. The ‘visual analogue scale’ (VAS) was not recorded in 35% of cases. At discharge, pain classified as moderate remained moderate in 48.8% and severe in 2.5%. Pain classified as severe at discharge remained severe in 33.3% and moderate in 27.8%. Conclusion: the low classification of pain intensity, the type of pain and the low recor-ding of the location of this, leaves serious doubts about the proper management of pain and, at the same time, reveals failures in the knowledge and education of the actors on the subject; a routine and careful recording of these clinical aspects is essential for an assessment of pain, symptom management and the pathology that causes it. The non-existence of protocols or management guidelines leaves each professional free to manage the patient’s pain at their own discretion, which again leads to irregular results in the patient’s pain condition.