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Recording Pain Score at Triage Improves Time to Analgesia

Summary and Comment |
February 10, 2012

Recording Pain Score at Triage Improves Time to Analgesia

  1. Richard D. Zane, MD, FAAEM

Median time to analgesia dropped from 123 minutes at baseline to 78 minutes 1 year after triage pain scoring became mandatory at an emergency department in Australia.

  1. Richard D. Zane, MD, FAAEM

In a prospective study at an emergency department in Australia, researchers evaluated the effect on time to analgesia of requiring triage nurses to record a numeric pain score in the electronic medical record for all patients and, separately, of a focused educational program for staff (1-hour didactic presentation on the need to improve time to analgesia).

During the 8 weeks before the scoring intervention, pain scores were recorded for 73% of patients; median time from patient arrival to administration of analgesia was 123 minutes. Eight weeks after the intervention, scores were recorded for 93% of patients (exceptions were critically ill patients who bypassed usual triage), and median time to analgesia decreased to 95 minutes. At 1 year, median time to analgesia was further reduced to 78 minutes. The focused educational program, which was initiated after the scoring intervention, did not have any additional effect on time to analgesia.

Comment

Pain scores should be recorded routinely at triage — just as vital signs are — and, like any potentially unstable vital sign, a moderate or severe pain score (i.e., ≥5) should prompt immediate action.

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