Healthcare providers regularly use verbal pain scales to assess Emergency Department (ED) patients with acute chest pain; however, the efficacy of displaying pain scales has not been assessed. This study evaluated whether display of pain scores facilitates physician monitoring of ED patients’ chest pain.
A randomized, prospective convenience-sample study of 49 adult ED patients presenting with chest pain to an urban Level 1 Trauma center (annual census 70,000) was undertaken. Chest pain levels were assessed every five minutes for one hour using a verbal numeric scale. Pain scores were not displayed for the Control group (n=17). Pain scales were displayed at the bedside only in the Bedside group (n=16), and at both the bedside and a central ED workstation in the Bedside/Central group (n=16). At the conclusion of the one-hour monitoring period, physicians were surveyed as to the usefulness of the pain displays.
Almost two-thirds (62.5%) of physicians caring for patients in the Bedside and Bedside/Central groups found the pain display provided useful information about their patient’s pain. Bedside/Central group physicians were nearly twice as likely as those in the Bedside group (81.3% versus 43.8%) to indicate that the pain display provided useful information about their patient’s pain (OR 5.6, 95% CI 1.1-27.5, p = 0.03). They were also more likely to indicate that the pain display made it easier to track their patient’s pain (OR 5.6, 95% CI 1.1-27.5, p = 0.03).
Chest pain displays facilitate physician monitoring of chest pain in the acute care section of the ED. Physicians benefit the most from pain displays present both at the bedside and at a central workstation.
Improving the assessment of acute chest pain will optimize patient care, especially treatment of time-sensitive cardiac disease. Future studies are needed to evaluate whether the display of pain scales in a continuous fashion, such as on a cardiac monitor alongside heart rate and blood pressure, will improve outcomes.
E.L. Senecal, None.