ERs get poor marks for treating pain

You can bet that many ERs won’t be happy with this study:

The end result, Dr. Todd said, was that as many as 40% of patients who go to the ER for pain relief are still in pain when they are discharged.
“The results of these studies show that persistent pain is common and substantial after emergency department discharge,” said Dr. Todd. “We, as emergency room doctors, do not do a good job at treating the patients who come in our doors.”

Perhaps naive Dr. Todd doesn’t see stories like these that makes ER physicians so suspicious.

Comments

Anonymous
I really don’t have time to treat pain in my ER. I would if I had the time, I just don’t I’m busy ordering tests so I don’t get lawsuits like “failure to diagnose” and trying to figure out if my patients have actualkly used cocaine or alcohol so when I send out I won’t be sued when they get hit by a bus, or go out and do more Cocaine, drio dead, and the family sues because I should have kept the patient; I should have known he was going to go out and smoke crack and die. I’m not whining, I’m speaking the truth.
Anonymous
The purpose of being a medical doctor is not to treat pain. The purpose is to accurately diagnose and then appropriately treat the underlying cause of the then diagnosed disease state. No one ever died from pain. They died from a delayed or lack of a diagnosis. That’s not to say pain relief should not be available, it’s important but not primary. I will admit that end of life palliative care is a legitimate exception.
Anonymous
Pain is a very strange thing. It is often a wonderful service that I can provide. I always ask patients if they would like something for pain. Often those who seem to be in legitimate pain will say “No”. Often those that say yes then later refuse it when the nurse brings it to them. On the other hand the ER is full of crackpots who who are sound asleep and need physical arousal when I go into the room and say their pain is 10/10 as soon as they wake up and say that they have a “really high pain tolerance, but I need 6mg of Dilaudid or 200mg of Demerol”
I also am amused by the charade of “I am allergic to Toradol, Stadol, tylenol, all NSAIDS, tramadol, Imitrex, Phenergan, etc., but doctor there is some medication that begins with a D… Dem?… Or Di? something like that….. do you know what I am talking about doctor? That really works great for me”
What a load of crap we have to shovel and sort through each day.
patch615
that article about self medicaton is scary. It’s further exemplification of our growing reliance on drugs for everything. Drugs are great tools, if used when needed and only when needed.
so much of what people are now “curing” with medications would be better dealt with in other ways. people don’t come to thier doctors for advice anymore, they come for scrips, and thats about it. it’s a sad trend.
Anonymous
I think perhaps part of the problem, also, is the patient’s expectations regarding pain. I’m an RN and also have gone to the ER in severe pain, but I have a condition that results in 24/7 pain that is always with me. While I’ve only gone to the ER twice for pain alone, I explained my condition, the reason I came to the ER, and “what usually works,” if asked. Of course, I don’t report any allergies to pain meds, and if toradol is offered, I’ll gladly take it.
Bottom line is that I don’t expect to leave the ER pain free. It’s just not realistic with my condition. However, the reason I’ve gone to the ER is because the pain became unmanageable with the usual abortives I use at home and I’m unable to wait until the next day. If I can get my pain down to a level which I consider tolerable (say…a 5/10 will do for me), then that’s a HUGE help. However, I’m still leaving in pain – I don’t consider that a failure to treat my pain by any means, though.
I’ve heard people complain about still being in pain when they leave the ER, but I have to wonder what their expectations are. Pain free isn’t always an option for every person. I think patients need to have an expectation for reduction of pain to a tolerable level, if it’s possible – but leaving in pain doesn’t always mean failure to treat. Some pain just doesn’t resolve….
Anonymous
I agree with the above. For many patients making them pain free would mean killing them with a lethal amount of pain medications.
Anonymous
So these pain specialists concluded that pain is not well controlled by the ER staff. I would like to see their algorithm for pain control in the ER. A study would be worthless without practical recommendations from these pain specialists whose only knowledge of the ER is from their 1 month rotation during internship. If they’re doing such a great job, why do I see hundreds of these chronic pain patients under their care in the ER still hurting?
Anonymous
Why do you care if these fucks have adequate pain control? These are the same assholes that would sue us if the slightest thing went wrong…just turf them off to pain management or a specialist…they will have to wait months to get an appointment…
Anonymous
Anon 6:34,
Are you the same person who posted awhile back about the *assholes* coming in for a *viral uri*? Just wondering based on profanity and level of hostility.
If so, have you thought about a new profession or finding a therapist? Seriously…your posts concern me. Your contempt for others is alarming in a profession such as this one.
Anonymous
anon, 7:05…..This guy has been spilling his venom on this site for months. The language is always the same. He hates everyone in life, Including himself. We try to ignore him. It would be really scary if this guy really were a Dr.
Anonymous
Anon 11:07,
Thanks for that! Now at least I know that when I cringe at what this guy is writing, I’m not alone! Scary, indeed…
Anonymous
yea I wish someone would find out if he is a doctor. He needs to lose his license. And another thing my daughter was injured she is only 3 her teeth on he upper lip caved in from slamming into a coffee table. Her roots had been exposed to the air and the roots went thru the gums. She was in intence pain. And she didnt get anything for 1 hour 17 mins for pain. I think the doctors and nurses should pay us damages and pay for her to see someone for her nightmares caused from trauma and pain not controlled by the ER doctor. They had the power and the medication to take the pain to a tolerable level they didnt. And guess what I had a video camera in my pocket and recorded the entire event. I showed it to the news media and they made a big deal out of it. The doctor on duty and the nurses are all being sued. I think they deserve it and need to be made example of. Come on my daughter doesnt abuse pain medicine and doesnt smoke cracxk or cocain. I wanted to beat the DR up when he got off work for lettin a little girl suffer like that. I think someone that would allow that is sick and has serious problems. I could see the DR with child porn on his pc and pics of kids in pain. There are laws that say they have to treat unbearable pain as soon as possible and in a timely manner. My daughters injury was the most severe one in the ER at the time. And she was placed last and was bleeding severly too. I am angry they could do that.Well I am suing them and I am going to win. I want his license pulled and all the nurses licenses pulled no money from the suit.
Anonymous
Here’s what I don’t understand…there are hundreds upon hundreds of articles, blogs and journal entries written by doctors and nurses complaining about the tactics, lies and schemes which drug-seekers participate and execute in, in ordrer to get their “fix.” My question is this: are any of you surprised? You’re doctors and nurses, so you went to medical school or nursing school right? Were you not trained in the scope of drug addiction? I guess more importantly, why are you all so suprised and complain about it? Had the “War on Drugs” ever accomplished anything? Do you think that just because you’re aware of the lies and scams these drug seekers give, you’re going to prevent them from getting their drugs? You look at all of the ER patients the same, that they’re really just in their to get a high off of a lying condition. You don’t really honestly believe anyone unless there is an acute, measurable method of diagnosing them – x-ray, ultrasound, etc. So, why whine and complain about the hoops you have to jump through, when really you treat everyone the same. Isn’t it sad and riddiculous that drug addicts have to resort to lies, scams and hundreds of hours of thoughts of how or where they’re going to get their next fix? Only one comment I’ve ever read in any of these stupid and redundant articles is how these folks were self-medicating themselves. Guess what: we don’t live in a society that cares about WHY people have the problems they have; we just want them to go away and quit bothering us. If people were properly receiving health/mental care they would be able to get to the root of the problem and why they “feel better” when taking a handful of Vicodin instead of some “sucessful, well-adapted” person can just have one and she doesn’t need another. PEOPLE ARE DIFFERENT. Some are screwed up, others grow up to be doctors. Quit complaining and whining about the problem and help be a part of the solution. Why not devote your intelligence and understanding of medicine to good use, like how to handle drug addiction POSITIVELY instead of making EVERYONE, including those in honest pain, suffer. Thanks so much.

ERs get poor marks for treating pain

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