Birutė Vabalaitė, Ieva Paliokaitė, Kęstutis Stašaitis, Dinas Vaitkaitis
Pain is one of the main reasons why people call for medical help. One of the major problems hindering the effective treatment of pain is an inadequate assessment of pain. The pain can not be properly managed without an accurate evaluation of its intensity as well as without treatment, once it is diagnosed. Aim of the study was to evaluate differences in pain assessment and treatment for patients who have suffered limb injuries, by staff of the Kaunas City Ambulance Service (AS) and the Emergency Department of the Hospital of the Lithuanian University of Health Sciences Kauno clinics (ED). Methods. A survey of the staff of the ED and the AS was conducted, and the study of Forms 110/A provided by the AS as well as the ED data bases of the patients who were treated at the ED because of a limb pain in 2015-2016 (ICD codes S.40-99) was performed. The staff survey included the data about their age, work experience, gender, position, the most commonly used pain assessment scales. Forms 110/A and the ED data bases provided information about the changes in patients’ pain scores and its treatment in the stage of pre-hospitalisation. Results. 62 employees of the KAS and 32 employees of the Emergency Department were surveyed, and 100 patients who complained of limb pain were selected from data bases, 52 female (52 per cent) and 48 male (48 per cent). Their average age was 52.77 ± 0.2. The staff survey revealed that the most frequent method to evaluate the pain score used by both the AS staff (58.1 per cent) and the ED staff (68.8 per cent) is the digital pain assessment scale. When the AS staff evaluated the pain score for the first time, it was 2.57 ± 1.43. However, when the staff of the Emergency Department repeatedly evaluated the pain score, it was 4.82 ± 1.93. The AS staff administered non-opioid analgesics at a minimum average pain score of 2.68 ± 0.02, and the Emergency Department staff administered them at the pain score of 4.96 ± 0.04 (p<0.05). Conclusions. The intensity of the pain caused by limb injuries was scored differently by the staff of the Ambulance Service and the Emergency Department. Patients at the ED received two times higher pain score than in Ambulance Service (4.82 ± 1.93 and 2.57 ± 1.43 respectively). The staff of Ambulance Service administered nonsteroidalanti-inflammatory drugs and opioid analgetics at lower pain scores than the staff of the Emergency Department.
Keyword(s): pain; analgesics; limb injuries; ambulance; emergency department.
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