Araştırma Çıktıları
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Item Pain management practices in the emergency departments in Turkey(WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2021-01-01) Cetin, Murat; Kaya, Bora; Kilic, Turgay Yilmaz; Hanoglu, Nazife Didem; Gokhan, Servan; Eroglu, Serkan Emre; Akar, Sakine Neval; Cekic, Ozgen Gonenc; Polat, Dicle; Ustsoy, Emre; Cinar, Orhan; Yilmaz, SerkanOBJECTIVES: This study aimed to evaluate pain management practices in the emergency departments (EDs) in Turkey and to evaluate the prevalence and etiologies of oligoanalgesia to identify possible improvement strategies.
METHODS: This multicenter cross-sectional observational study was conducted in 10 tertiary care hospitals in Turkey. Patients who were admitted to the ED with pain chief complaints were included in the study. Both patients and physicians were surveyed with two separate forms by the research associates, respectively. The patient survey collected data about the pain and the interventions from the patients' perspective. The pain was evaluated using the Numerical Rating Scale. The physician survey collected data to assess the differences between study centers on pain management strategies and physician attitudes in pain management.
RESULTS: Ten emergency physicians and 740 patients (male/female: 365/375) enrolled in the study. The median pain score at admission at both triage and ED was 7 (interquartile range: 5-8). The most frequent type of pain at admission was headache (n = 184, 24.7\%). The most common analgesics ordered by physicians were nonsteroidal anti-inflammatory drugs (n = 505, 67.9\%), and the most frequent route of administration was intramuscular injection (n = 396, 53.2\%). About half of the patients (n = 366, 49.2\%) received analgesics 10-30 min from ED admission. The posttreatment median pain score decreased to 3 (P < 0.001). About 79.2\% of patients did not need a second analgesic administration (n = 589), and opioid analgesics were the most frequently administered analgesic if the second application was required. Physicians prescribed an analgesic at discharge from the ED in 55.6\% of the patients (n = 414) and acute pain was present in 7.5\% (n = 56) of the patients.
CONCLUSION: Our study on the pain management practices in the EDs in Turkey suggested that high rate of intramuscular analgesic use and long emergency room stay durations are issues that should constitute the focus of our quality improvement efforts in pain management.Item Analgesic Treatment in Patients With Acute Extremity Trauma and Effect of Training(ELSEVIER SCIENCE BV, 2012-01-01) Akarca, Funda Karbek; Karcioglu, Ozgur; Korkmaz, Tanzer; Erbil, Bulent; Demir, Omer FarukObjectives Studies indicate that emergency physicians (EP) under-evaluate and undertreat the pain experienced by their patients. The objective of this study was to investigate how EPs treat pain in adult patients with limb trauma and to determine if their behavior could be affected by training in the short-term. Methods All consecutive adult patients admitted to the university-based emergency department (ED) within two months were enrolled in the study. The patients were asked to rate their level of pain on the NRS in triage. NRS scores were noted again after 30 minutes and 60 minutes, and on discharge. Patient prescriptions were also tracked to identify any analgesics. After completion of the pre-education phase, four hours of training on pain evaluation and treatment were undertaken under the leadership of experienced staff faculty. The aforementioned outcomes were gathered again in a 30-day period after training and we compared the pre and post training periods. Results A hundred and forty-three patients (81 female) were enrolled in the pre-education phase, and 130 patients (58 female) were eligible for the post-education phase. The mean NRS scores of the females noted on admission were significantly higher than those of the males (7.4 +/- 2.3 vs. 6.7 +/- 2.5, respectively