Inconsistencies among pain management protocols in emergency medicine have been well documented. This study conducts a poll of pain management practices in emergency departments (EDs) around the world to highlight these variable treatment protocols and evaluate them in the context of recent literature and their broader implications for patient care.
A digital questionnaire was used to assess pain management practices. Questions addressed the documentation of pain, existence of specific protocols, types of drugs used, and methods of drug administration. Forty hospitals across 22 countries were represented.
Eighty percent of the emergency departments surveyed reported that pain was both evaluated and documented. A verbal numerical scale (from 0-10) was the most frequently used method for pain assessment. More than half of the emergency departments (57.5%) indicated specific pain protocols for particular conditions. However, these conditions were not found to be mandatory by all institutions. Furthermore, only 27.5% of departments reported training programs in pain management. Multi-trauma pain management was the most consistent finding with 100% of hospitals reporting analgesia administration. For oral analgesics, Paracetamol was the most used (67.5%), followed by NSAIDS (62.5%) and opioids (30%). The most common IV analgesics used were Morphine (92.5%) and ketamine (62.5%).
Pain management and assessment protocols vary greatly among EDs worldwide. Analgesic treatment in trauma settings is the only uniform finding. Variation in certain medical practices can be beneficial in some circumstances; however, with regard to analgesia practices, such discrepancies can impair pain management and quality of care overall.