ED Pain Assessment Tool Needed
Challenges exist to developing an effective pain assessment tool for patients presenting to the emergency department.
LAS VEGAS—A rapid pain assessment tool is needed for the emergency department (ED), and although many tools exist, data that assess using these tools in the ED setting are limited, according to a presentation at PainWeek 2016.1
Sophia Sheikh, MD, an assistant professor in the department of emergency medicine at the University of Florida Jacksonville, noted in her presentation that an ideal pain assessment should include information about a patient's functionality, mental health status (including pain catastrophizing), substance abuse history, and opioid addiction risks, in addition to taking the patient's history and physical examination.
Dr Sheikh said that it is important for physicians in the ED to consider patients' subjective pain assessments by specifically asking them how the pain is affecting their function and then adjusting treatment approaches based on findings from a physical examination.
The Defense and Veterans Pain Rating Scale is a good pain rating scale that could be considered for the ED setting, Dr Sheikh explained. The strength of the scale lies in its strong visuals that depict both numbers and facial expressions to help patients communicate how much pain they may be experiencing. One limitation of the use of this scale in the ED setting, Dr Sheikh noted, is due to the fact that it has mostly been studied in military patients who are a very different demographic than nonmilitary ED patients.
Until an ideal ED pain assessment tool is identified, communication with patients remains of paramount importance, according to Dr Sheikh.
"Find out if their pain is tolerable or intolerable, identify a common goal, set a realistic expectation of what's going to happen in the ED, and tailor your assessment to the patient," Dr Sheikh concluded. "Also, recognize the role that psychosocial factors play in pain assessments, and make sure that reassessments are conducted. It may be tempting in our setting to let the nurses take care of that, but we should be doing that. We need to know about how our patients are doing."
1. Sheikh S. How to complete a rapid pain assessment in a busy ED. Presented at: Pain Week 2016. Las Vegas, NV; September 6-10, 2016.