Do ethnic differences still exist in pain assessment and treatment in the emergency department?

Although the provision of timely and appropriate analgesia is a primary goal of Emergency Department (ED) staff, pain continues to be undertreated and some evidence supports the existence of pain treatment disparities. Despite strong incentives from accreditation organizations, pain management in the ED may still be inconsistent and problematic. The purpose of this research study was to conduct a retrospective chart review to investigate pain assessment and treatment for 200 adults (≥18 years old) admitted to the ED suffering from long-bone fractures. An additional purpose was to investigate demographic variables, including ethnicity, to determine if they influenced pain assessment, pain treatment, and wait times in the ED. Although assessment and treatment of pain is universally recognized as being important and necessary to provide optimal patient care, only 52% of patients in this study were assessed using a pain intensity scale, with 43% of those assessed reporting pain as ≥5 on a 0-10 pain intensity instrument. Pain medication was administered to 75% of the patients, but 25% of the patients received no medication. Only 24% of those receiving a pain medication were reassessed to determine pain relief. Compounding these problems were wait times for analgesia of >1 hour. Although the influence on pain management related to ethnicity was not a factor in this study, other findings revealed that undertreatment of pain, inadequate assessment, lack of documentation of pain, and lengthy wait times persist in the ED.