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Review

Acute Traumatic Pain in the Emergency Department

1
Department of Integrated Research and Innovation Activities, Unit of Translational Medicine AON SS, Antonio e Biagio e Cesare Arrigo H, 15121 Alessandria, Italy
2
Department of Physiology and Pharmacology, Sapienza University of Rome, 00185 Rome, Italy
3
Emergency Medicine and Surgery, IRCCS Fondazione Policlinico San Matteo, 27100 Pavia, Italy
4
Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Diseases 2023, 11(1), 45; https://doi.org/10.3390/diseases11010045
Submission received: 5 December 2022 / Revised: 1 February 2023 / Accepted: 1 March 2023 / Published: 3 March 2023

Abstract

Trauma is a major cause of mortality throughout the world. Traumatic pain—acute, sudden, or chronic—is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage”. Patients’ perceptions of pain assessment and management have become an important criterion and relevant outcome measure for healthcare institutions. Several studies show that 60–70% of ER patients experience pain, and more than half of them express a feeling of sorrow, which can be moderate or severe, at triage. The few studies that have analyzed how pain is assessed and managed in these departments agree that approximately 70% of patients receive no analgesia or receive it with remarkable delay. Specifically, less than half of the patients receive treatment for pain during admission and 60% of discharged patients have higher intensity pain than at admission. Trauma patients are also the ones who most commonly report low satisfaction with pain management. Associated with this lack of satisfaction, we can describe the poor use of tools for measuring and recording pain, poor communication among caregivers, inadequate training in pain assessment and management, and widespread misconceptions among nurses about the reliability of patients’ estimation of pain. The aim of this article is to review the scientific literature to explore the methodologies of pain management in trauma patients attending the emergency room and analyzing their weaknesses as a starting point to improve the approach to this, unfortunately too often, underestimated issue. A literature search was performed using the major databases to identify relevant studies in indexed scientific journals. The literature showed that the multimodal approach in trauma patients is the best approach to pain management. It is becoming increasingly crucial to manage the patient on multiple fronts. Drugs acting on different pathways can be administered together at lower doses, minimizing risks. Every emergency department must have staff trained in the assessment and immediate management of pain symptoms as this allows the reduction of mortality and morbidity and shortens hospital stays, contributing to early mobilization, reduced hospital costs, and enhanced patient satisfaction and quality of life.
Keywords: emergency; traumatic pain; pain management; trauma management; acute pain emergency; traumatic pain; pain management; trauma management; acute pain

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MDPI and ACS Style

Zanza, C.; Romenskaya, T.; Zuliani, M.; Piccolella, F.; Bottinelli, M.; Caputo, G.; Rocca, E.; Maconi, A.; Savioli, G.; Longhitano, Y. Acute Traumatic Pain in the Emergency Department. Diseases 2023, 11, 45. https://doi.org/10.3390/diseases11010045

AMA Style

Zanza C, Romenskaya T, Zuliani M, Piccolella F, Bottinelli M, Caputo G, Rocca E, Maconi A, Savioli G, Longhitano Y. Acute Traumatic Pain in the Emergency Department. Diseases. 2023; 11(1):45. https://doi.org/10.3390/diseases11010045

Chicago/Turabian Style

Zanza, Christian, Tatsiana Romenskaya, Marta Zuliani, Fabio Piccolella, Maria Bottinelli, Giorgia Caputo, Eduardo Rocca, Antonio Maconi, Gabriele Savioli, and Yaroslava Longhitano. 2023. "Acute Traumatic Pain in the Emergency Department" Diseases 11, no. 1: 45. https://doi.org/10.3390/diseases11010045

APA Style

Zanza, C., Romenskaya, T., Zuliani, M., Piccolella, F., Bottinelli, M., Caputo, G., Rocca, E., Maconi, A., Savioli, G., & Longhitano, Y. (2023). Acute Traumatic Pain in the Emergency Department. Diseases, 11(1), 45. https://doi.org/10.3390/diseases11010045

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