Università degli studi di Modena e Reggio Emilia

The pain, acute and chronic , is being recognized for a few years as the fifth vital sign. In particular, the acute pain is the most frequent one, presenting symptom in emergency departments , especially in the emergency room (from 52% to 78% of the accesses in a variety of forms ) . Despite the high prevalence , several studies have shown how the pain is not being adequately recognized and treated . This phenomenon is defined oligoanalgesia (undertreatment of pain) , which can be summarized as insufficient recognition and / or treatment of pain. In recent years, the Italian Parliament has intervened on the importance of an effective and widespread treatment of pain, by the Law no. 38 of March 15, 2010 and the projects of  "Hospital without pain." The lack of attention to the treatment of pain in the emergency department shows several causes , most of which come from cultural barriers, cognitive and psychological ones. The specific training of the nurse and the doctor on the recognition and treatment of pain during the course of studies is widely neglected. With this retrospective study we wanted to analyze the protocol of early treatment of pain using the triage nurse at the hospital emergency room NOCSAE of Modena , and it was analyzed how often it was used in the period between June 1 and December 31, 2012.

Over this period,  26,948 accesses in the emergency room were recorded, of which about 50 % had a disease that caused pain, but only to 1,235 people the protocol of early treatment of pain had been properly applied by the triage nurse . Despite the large amount of work for triage nurse , 26,948 patients in six months correspond approximately to a new patient every 10 minutes , the protocol appears to be a practice still uncommon.