Oligoanalgesia in a rural emergency department

Vlahaki, Dean and Milne, William Kenneth (2008) Oligoanalgesia in a rural emergency department. Canadian journal of rural medicine, 13 2: 62-67.

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Author Vlahaki, Dean
Milne, William Kenneth
Title Oligoanalgesia in a rural emergency department
Journal name Canadian journal of rural medicine   Check publisher's open access policy
ISSN 1203-7796
Publication date 2008
Year available 2008
Sub-type Article (original research)
Open Access Status File (Publisher version)
Volume 13
Issue 2
Start page 62
End page 67
Total pages 6
Place of publication Ottawa, ON Canada
Publisher Canadian Medical Association,Association Medicale Canadienne
Collection year 2009
Language eng
Subject 2700 Medicine
Formatted abstract
 OBJECTIVE: Multiple studies conducted over many years have demonstrated that pain is poorly managed in the emergency department (ED). This phenomenon has been referred to in the medical literature as "oligoanalgesia." However, little is known about whether oligoanalgesia occurs in a rural ED. National Ambulatory Care Reporting System data from 2003 for a small rural hospital in Ontario showed patients were satisfied with the amount of pain medicine they received in the ED. We designed a study to replicate a published urban study that investigated the use of analgesia in isolated lower limb injuries. Our objective was to see if oligoanalgesia was also a problem in a rural ED.

METHODS: In 2003 we conducted a retrospective chart review of patients who presented to the South Huron Hospital ED with isolated lower extremity injuries for which radiographs of the foot, ankle or both were obtained. Demographics of the ED patients with lower extremity injuries were quantified. Other parametres included whether or not patients received analgesia in the ED; how long it took to get assessed, treated and discharged; whether patients received any analgesia upon discharge; what type of analgesia they received; and whether it required a prescription.

RESULTS: A total of 189 patients met inclusion criteria, with 35 fractures identified (18.5%). Sixty-three percent of patients were male. The average age was 32.6 years. The mean Canadian Emergency Department Triage and Acuity Scale level was 4.4. The mean time to physician assessment was 31.6 minutes. The mean length of time spent in the ED was 74 minutes. Over one-half of the patients received analgesia upon discharge from the ED whether or not they had a fracture. In addition, 73% of the people in the fracture group received analgesia requiring a prescription, versus only 46% in the nonfracture group. Narcotics were used more often in the fracture group than in the nonfracture group (26% v. 6%).

CONCLUSION: The phenomenon of oligoanalgesia was not observed as often in our rural ED for isolated lower limb injuries, when compared with the published urban study.
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Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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