Pain in patients attended at risk classification of an emergency service

ABSTRACT BACKGROUND AND OBJECTIVES: Pain is a major symptom responsible for the search for urgency care. This study aimed at checking the presence of pain in patients attending the risk classification. METHODS: This is a cross-sectional and descriptive study carried out at an urgency care unit, using a form with socio-demographic and clinical data, risk classification, analgesia and pain record on medical charts. Pain Management Index proposed by the World Health Organization was calculated. RESULTS: From 102 patients included in the study, 82 (80.2%) reported pain, 45 (54.9%) were females, 48 (58.5%) were married, most (62 - 75.6%) lived in Greater Aracaju, 28 (34.1%) were classified as yellow. Acute, severe to moderate pain was the most frequent. In 71 (86.6%) cases, continuous pain has motivated the search for urgency care. Pain recording was present in almost all medical charts, being 80.5% performed by physicians. Simple analgesics and non-steroid anti-inflammatory drugs were the most frequently prescribed analgesics (59 - 72%). Pain management was inadequate in 86.6% of cases and there has been wide variation between admission and administration of first analgesia (mean: 94.5 min; min-max: 8-360 min). CONCLUSION: The lack of analgesic protocols at risk classification may impair adequate pain management.

摘要

背景与研究目的
疼痛是促使患者寻求急诊诊疗的主要症状。本研究旨在调研接受急诊风险分级的就诊患者的疼痛发生情况。

研究方法
本研究为在急诊科室开展的横断面描述性研究，采用包含社会人口学资料、临床数据、风险分级、镇痛方案及病历疼痛记录的调研表单进行数据采集。本研究计算了世界卫生组织（World Health Organization）提出的疼痛管理指数（Pain Management Index）。

研究结果
本研究共纳入102例患者，其中82例（80.2%）主诉存在疼痛；45例（54.9%）为女性，48例（58.5%）已婚；多数患者（62例，75.6%）居住于大阿拉卡茹地区，28例（34.1%）被分级为黄色风险等级。急性中重度疼痛为最常见的疼痛类型。71例（86.6%）患者因持续性疼痛寻求急诊诊疗。几乎所有病历均记录了疼痛相关信息，其中80.5%由医师完成记录。临床最常开具的镇痛药物为简单镇痛药与非甾体抗炎药（non-steroid anti-inflammatory drugs），共计59例（占比72%）。86.6%的病例存在疼痛管理不充分的情况，且患者从就诊到首次接受镇痛治疗的间隔时间差异较大（平均时长：94.5分钟；范围：8~360分钟）。

结论
急诊风险分级环节缺乏镇痛诊疗规范，可能会对疼痛的规范化管理造成不利影响。