Right Choice Index

Page Contents

Pain of an emergency

Myths

Advice

Be assertive

Benefits of pain relief

Questions to ask

Our pain management

Site Contents

Patients & visitors

Medical professionals

Yale-New Haven
Children's Hospital

Yale-New Haven
Psychiatric Hospital

General information

Calendar

Online resource

Press information

Phone Numbers

Directory assistance
(203) 688-4242

Patient Information
(203) 688-4177

Adult emergency
(203) 688-2222

Children's emergency
(203) 688-3333

Admitting
(203) 688-2221

Children's admitting
(203) 688-3331

Psychiatric admitting
(203) 688-9907


Mailing address:

Yale-New Haven Hospital
20 York Street
New Haven, CT 06510-3202

Pain in the Emergency Department:

The Right Hospital Will Treat Pain Properly

The pain of an emergency
Pain is a very real phenomenon whether it is the persistent ache of a broken ankle, a sharp jab from a kidney stone or heavy pressure in the chest. Pain can be confusing, stressful and frightening.

In some settings, physicians have historically had concerns about treating their patients' pain. Some believed masking symptoms would make the physical examination more difficult. Others were concerned patients would become addicted to pain medications. But pain is an urgent problem that needs immediate attention. Today, the organization which accredits hospitals—the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)—evaluates hospitals on pain management.

Common myths about pain
Myth #1: When doctors and nurses gather information on new patients, pain is the least of their concerns.
Fact: Nurses are beginning to count pain as a fifth vital sign, along with blood pressure, temperature, pulse and respiration. When a patient comes into the emergency department, the nurse records his level of pain along with the other vital signs when she or he fills in his chart.

Myth #2: Emergency department doctors avoid giving pain medication because it can make the physical examination more difficult.
Fact: Prompt, appropriate treatment of pain facilitates a successful physical exam and enhances the patient's ability to undergo any tests that might be necessary to make an accurate diagnosis.

Myth #3: The medications often used for pain relief cause bad side effects and may lead to addiction.
Fact: Addiction to pain relief medicines is rare when they are properly prescribed and taken as directed. Also, doctors today are replacing some traditional medications with safer ones and establishing protocols that encourage adequate dosing.

Myth #4: Pain relief usually means injections of medication.
Fact: While some patients may need medication such as morphine through an I.V., pain relief can be as simple as ibuprofen and ice for an ankle sprain. It all depends on the complaint and the patient.

Advice from Yale-New Haven physicians and nurses

• Chart your pain on the patient pain scale, which ranges from 0 (no pain at all) to 10 (the worst pain you've ever experienced). If your pain seems to be higher than 5 on the scale, let the doctor or nurse know right way.
• Make sure to keep your nurse informed if your number on the pain chart changes. Your nurse is responsible for working with you to design an appropriate pain management plan.
• Children or patients who have trouble reading may be asked to assess their pain on a chart with faces that range from happy to sad.
• If a patient is unable or unwilling to speak up about pain, family members should keep track of it and keep emergency department staff apprised.
• Describe what your pain feels like. Use words like sharp, stabbing, dull, aching, burning, tingling, throbbing, deep, pressing, etc. Is the pain always there or does it go away sometimes? Does the pain get worse when you move in certain ways?
• Anxiety, which is very common in an emergency department, might make your pain worse. Tell your nurse if you are highly anxious—the anxiety might be treated as well as the pain.
• Tell your nurse if you are allergic to any medications or have concerns or questions about your medications.

It's important to be assertive
Patients should speak up right away about their pain and anxiety surrounding it, especially in an emergency department where doctors and nurses are juggling many responsibilities. Pain can be very subjective. If you don't keep speaking up, emergency department staff may not realize how frustrated you are. Two patients with the same condition can experience pain quite differently, and people from different cultural backgrounds might show it differently. Those who don't make an effort to let the doctors and nurses in the emergency department know how they feel risk suffering unnecessarily. Remember, hospitals are required to treat pain promptly.

Benefits of pain relief

• You can help your physician ensure a good outcome by asking for pain treatment as soon as possible. The benefits go beyond relief from the immediate pain.
• Blocking pain before it becomes overwhelming helps manage subsequent pain intensity and reduces the need for pain medications.
• Controlling early acute pain may cut the risk of developing chronic debilitating pain.
• Studies have shown that pain above a certain level can interfere with your ability to heal.
• If you figure out how to control your pain in the emergency department, it will make it easier to work with your health care team on pain relief if you are admitted to the hospital.

Questions to ask in the emergency department

• What is the doctor's philosophy of pain management?
• What is the hospital's policy on pain management?
• Does the emergency department have guidelines for pain management?
• If you don't want to take medication, are there alternative ways of treating pain in your particular situation?

Pain management at Yale-New Haven Hospital
The Emergency Department at Yale-New Haven Hospital (YNHH) has pain management training for its physicians and nurses. YNHH also considers educating Emergency Department patients about the process of pain management to be an integral aspect of their care plan. The education process starts in the Emergency Department and follows the patient throughout his or her stay in the hospital and in discharge planning.

Last revised: March 8, 2004 (cfs)

Home page URL: http://www.ynhh.org

All information is intended for your general knowledge and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen.