Oligoanalgesia (February 2015)

Summary

Oligoanalgesia is defined as failure to provide analgesia in patients with acute pain. More than 60% of patients seen in the emergency department (ED) have pain as their primary symptom; however, multiple studies have shown that olioganalegesia continues to be a major problem in the ED.

Content

Myths of pain:

• Myth 1: Pain meds compromise the abdominal exam.
• Myth 2: Treatment of pain will compromise a patient’s decision making capacity.
• Myth 3: Opiophobia: The fear of addiction
• Myth 4: She's not in pain! I just saw her sleeping!

How can we improve?

• First: Stop saying that it’s not you. It is you! You suck at managing pain. Perhaps not in everyone, but you’re definitely mistreating someone. Once we accept this fact, we may become cognizant and then able to improve our practices.
• Second: Educate thyself. Tintinalli’s actually has a whole chapter on acute pain management. Studies show that short training sessions led providers to give more analgesia with improvement in patient satisfaction (5).
• Third: Simply ask. Ask your patients if they have pain and ask them if they want pain medication.
• Fourth: Don’t get caught up by stupid myths. Your patient is in pain, treat him!
• Last: Do not give in to the Great Opiophobia! We are emergency physicians and we aren’t afraid of anything!