A week of pain in the Emergency Department

Background: Pain is a common complaint in patients attending the emergency department and historically it is under-assessed and undertreated. Previous research is heterogeneous and does not well describe pain in emergency departments (EDs) over time. Our aim was to describe pain in a UK emergency department by using a sample that included every adult attendance over the course of one week. Methods: We retrospectively reviewed every adult attendance (N=1872) over 1 week to the emergency department 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: 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 Emergency Department over one week. This information will underpin the design of future studies aimed at improving patient care in this important area of emergency medicine practice.