The treatment of pain in Italian Emergency Units

Key words: Emergency-urgent care setting, Pain localization and intensity, Pain scales, Analgesic drugs

Background - Pain is a crucial aspect in the emergency-urgent care setting.
Objective - This paper aims to evaluate the satisfaction expressed by accompanying adults and children on pain management in the Italian Emergency Units (EUs) that are members of PIPER Project (Pain In Paediatric Emergency Room).
Materials and Methods - Face-to-face surveys were carried out by training interviewers over a weekend period in 29 Italian EUs. Questionnaires were addressed to accompanying adults and their 3-16 year-old children, who were evaluated for pain in EUs. In the questionnaires the level of satisfaction regarding the management of symptom and quality perceived about interventions were evaluated.
Results - 1,581 questionnaires were administered (923 to parents or caregivers; 658 to children). 95% of adults referred high level of satisfaction. According to accompanying adults, 73.6% of children received questions about pain localization and intensity by health professionals and in 24.7% of cases validated pain scales were administered. In EUs, 47.5% of adults referred the administration of analgesic drugs with waiting times that in 50.5% of cases were lower than 20 minutes. 95.3% of children confirmed that they had received questions regarding site of pain and 46% of cases confirmed the use of validated pain scale. 23% of children referred a reduction of pain after administration of painkillers in EUs.
Conclusions - On the basis of the collected data, a strong dichotomy emerged between users’ satisfaction and level of managing of pain. In one child out of 4, the symptom was measured and in one out of 2 a pharmacological therapy was prescribed. Probably, there are many causes: poor information and education induced users to evaluate positively a poor management path.