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Pain assessment

Assessing acute pain in the emergency department

Shona McIntyre

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Abstract

The principles of pain assessment in patients in the emergency department are applicable anywhere patients with acute pain are seen, including general practice. Pain should be assessed early and frequently, at rest and on movement, with objective measurements of severity, to guide analgesia.

Key Points

  • All patients in the emergency department should be assessed for pain early, beginning at triage, and frequently to ensure early appropriate analgesia.
  • Pain severity can be assessed with the numerical rating, visual analogue or faces scale or, for infants, the FLACC (face, legs, activity, cry and consolability) scale.
  • The character, mechanism and history of the pain and presence of chronic pain should also be assessed, and the patient examined for physical signs of pain.
  • Barriers to pain assessment can include patient communication difficulties, procedures and attitudes of healthcare providers.

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