Heightened pain perception in illicit substance-using patients in the ED: implications for management.

Background: Substance users are commonly perceived to overstate their pain. Few data exist comparing pain intensity, perception, and related psychiatric comorbidities in the emergency department (ED) population.

Objective: To compare pain severity, duration, interference with function, and psychiatric and mood disturbance in substance-using (SU) and non-substance-using (NSU) patients in the ED.

What patients with abdominal pain expect about pain relief in the emergency department.

Introduction: Abdominal pain is the leading cause of patient visits to the emergency department. Although patients present to the emergency department in search of relief from pain, few experience complete pain relief. The purpose of this study was to describe patients' expectations for pain relief and how communication of their pain to nurses and physicians affected their overall pain relief.

Changing opioid use for right lower quadrant abdominal pain in the emergency department.

Objectives: To compare the use of opioid analgesia in the treatment of emergency department patients with acute right lower quadrant (RLQ) abdominal pain between 1998 and 2003 and to explore the relationship between opioid use and abdominal computed tomography (CT) scanning.

Methods: This was a retrospective cohort study of patients presenting in 1998 and 2003 to an urban emergency department with a triage complaint of RLQ pain. The authors abstracted use and timing of abdominal CT scanning and opioid analgesia.

Factors affecting emergency department opioid administration to severely injured patients.

Objectives: Studies of emergency department (ED) pain management in patients with trauma have been mostly restricted to patients with fractures, yet the potential for undertreatment of more severely injured patients is great. The authors sought to identify factors associated with failure to receive ED opioid administration in patients with acute trauma who subsequently required hospitalization.

Methods: At an urban Level 1 trauma center and teaching hospital, a retrospective cohort study of trauma team activation patients requiring hospitalization between January 1 and December 31, 1999, was conducted.

Lack of association between patient ethnicity or race and fracture analgesia.

Objective: Ethnic and racial differences in the provision of emergency department (ED) analgesia for long-bone fractures have recently been reported in two large cities. The authors sought to determine, in a third city, whether nonwhite patients with long-bone fractures were less likely to receive analgesics than white patients with similar injuries.

Methods: At an urban Level 1 trauma center and teaching hospital, a retrospective cohort study was conducted of all ED patients aged 18 to 55 years seen from July 1, 1998, through June 30, 1999, with an ED discharge diagnosis of isolated long-bone fracture identified by ICD-9 codes 812, 813, 821, and 823.