Pain management of trauma patients in the emergency department: a study in a public hospital in Iran

•The pain reduction was significant in the first hour, but after that the pain severity was almost stable.•Patients with higher pain intensity were more likely to receive interventions.•The pain intensity was more than pain score of 4, revealing moderate pain in most patients after 4 h.•In spite of severe pain many patients did not receive analgesics, which is the most efficient method for pain relief in ED.

BackgroundPain is a common problem which the patients in emergency departments (ED) face, especially trauma patients under treatment may suffer from physical, psychological and ethical issues. The purpose of this study was to evaluate traumatic pain management in the emergency department at a public hospital in Iran in 2014.MethodsThis observational prospective study was conducted on 450 trauma patients admitted to a trauma emergency department. The tool used in this study has three parts: demographic data, data of trauma, and VRS (Verbal Rating Scales) score at a 7-point scale-at the arrival time to 4 h later. The statistical analysis was conducted by using Mann-Whitney and Kruskal-Wallis tests, repeated measures, survival analysis, and multiple regression analysis.ResultsThe majority of the samples were male (83.3%) with the mean age of 35.2 years. The patients mostly suffered from contusions and strains (42.4%). The majority of the patients [274 patients (60.8%)] received no intervention for pain relief and only 60 patients (13.3%) received analgesics. The mean time period of the first analgesic utilization was 41 (±20.4) minutes. Pain in admission, pain assessment, and receiving intervention could explain the 32% of pain reduction. No other variables such as age, sex, education, kind of trauma, and the shift of admission were involved in pain reduction.ConclusionsThis research study demonstrated that comprehensive, adequate pain management remains an obscure goal within the emergency nursing setting. There is a need to undertake further research and develop educational programs on effective analgesic practice in pain management.