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Vital Signs Are Not Associated with Self-Reported Acute Pain Intensity in the Emergency Department
- Source :
- CJEM. 18:19-27
- Publication Year :
- 2015
- Publisher :
- Springer Science and Business Media LLC, 2015.
-
Abstract
- ObjectivesThis study aimed to ascertain the association between self-reported pain intensity and vital signs in both emergency department (ED) patients and a subgroup of patients with diagnosed conditions known to produce significant pain.MethodsWe performed a retrospective analysis of real-time, archived data from an electronic medical record system at an urban teaching hospital and regional community hospital. We included consecutive ED patients ≥16 years old who had a self-reported pain intensity ≥1 as measured during triage, from March 2005 to December 2012. The primary outcome was vital signs for self-reported pain intensity levels (mild, moderate, severe) on an 11-point verbal numerical scale. Changes in pain intensity levels were also compared to variations in vital signs. Both analyses were repeated on a subgroup of patients with diagnosed conditions recognized to produce significant pain: fracture, dislocation, or renal colic.ResultsWe included 153,567 patients (mean age of 48.4±19.3 years; 55.5% women) triaged with pain (median intensity of 7/10±3). Of these, 8.9% of patients had diagnosed conditions recognized to produce significant pain. From the total sample, the difference between mild and severe pain categories was 2.7 beats/minutes (95% CI: 2.4−3.0) for heart rate and 0.13 mm Hg (95% CI: -0.26−0.52) for systolic blood pressure. These differences generated small effect sizes and were not clinically significant. Results were similar for patients who experienced changes in pain categories and for those conditions recognized to produce significant pain.ConclusionHealth care professionals cannot use vital signs to estimate or substantiate self-reported pain intensity levels or changes over time.
- Subjects :
- Adult
Male
Canada
medicine.medical_specialty
Adolescent
Vital signs
Severity of Illness Index
Young Adult
03 medical and health sciences
Hospitals, Urban
0302 clinical medicine
Internal medicine
Heart rate
medicine
Humans
Renal colic
Acute pain
Aged
Retrospective Studies
Vital Signs
business.industry
Incidence
030208 emergency & critical care medicine
Emergency department
Middle Aged
Acute Pain
Triage
Intensity (physics)
Blood pressure
Emergency Medicine
Physical therapy
Female
Self Report
medicine.symptom
Emergency Service, Hospital
business
030217 neurology & neurosurgery
Follow-Up Studies
Subjects
Details
- ISSN :
- 14818043 and 14818035
- Volume :
- 18
- Database :
- OpenAIRE
- Journal :
- CJEM
- Accession number :
- edsair.doi.dedup.....8d48d460e4e12d4d7ff3356dbdf51c60