Acute Pain Management

The University of Utah, Division of Emergency Medicine is committed to high quality clinical research in acute/emergency pain management under a program now coordinated by Troy Madsen, MD, Research Director, Division of Emergency Medicine University of Utah.

Pain is the most common reason why people seek emergency department care. Despite this, pain management in the emergency department setting is poorly studied and poorly applied. In studies at different emergency departments in the US, only 38-70% of patients presenting to the ED receive pain medication. In addition, there are no accepted outcomes measures for pain and pain relief in the ED setting.

The University of Utah established a program to study pain and pain management in the emergency department setting in 1999. The development of Health Education Course 5800, Research in Emergency Medicine provided a means to study pain in the clinical setting of the ED. Currently the ED is staffed from 0800 to midnight seven days/week with research associates trained to collect pain related clinical data. This program has generated quality improvement pain data on over 9000 patients in the last 7 years.

A partnership with C. Richard Chapman, PhD Professor, Department of Anesthesiology generated an NIH funded study to improve the measurement of acute pain, now in phase II of development.

Recent work includes:

PUBLICATIONS

1. Fosnocht, D.E. and E.R. Swanson, Use of a triage pain protocol in the ED. Am J Emerg Med, 2007. 25(7): p. 791-3.

2. Todd, K. H., Ducharme, J., Choiniere, M., Crandall, C. S., Fosnocht, D. E., Homel, P., Tanabe, P., Pain in the emergency department: results of the pain and emergency medicine initiative (PEMI) multicenter study. J Pain, 2007. 8(6): p. 460-6.

3. Bossart, P., Fosnocht, D.E, and E. Swanson, Changes in heart rate do not correlate with changes in pain intensity in emergency department patients. J Emerg Med, 2007. 32(1): p. 19-22.

4. Fosnocht, D.E., E.R. Swanson, and E.D. Barton, Changing attitudes about pain and pain control in emergency medicine. Emerg Med Clin North Am, 2005. 23(2): p. 297-306.

5. Fosnocht, D.E., et al., Correlation of change in visual analog scale with pain relief in the ED. Am J Emerg Med, 2005. 23(1): p. 55-9.

ABSTRACTS

1. Measurement of Acute Pain With Word List Descriptors
Fosnocht, D.E, C.R. Chapman, G.W. Donaldson, Annals of Emergency Medicine
September 2007 (Vol. 50, Issue 3, Pages S121-S122)

2. Ease of Use, Utility and Accuracy of the 11 Point (0-10) Numeric Rating Scale
Fosnocht, D.E, E.R. Swanson, C. Jowers, Annals of Emergency Medicine
September 2007 (Vol. 50, Issue 3, Page S122)

3. A Comparison of Triage Systems and Their Impact on Initial Pain Management: A Multicenter Study J. Ducharme, P. Tanabe, K. Todd, P. Homel, Fosnocht, D.E, M. Choiniere, C. Crandall, Annals of Emergency Medicine
October 2006 (Vol. 48, Issue 4, Page 61) 

4. What Does a Pain Score of “X” Mean Anyway? Classification of NRS Pain Severity Scores for ED Patients Based Upon Interference with Function
Fosnocht, D.E, P. Homel, K. Todd, C. Crandall, M. Choiniere, J. Ducharme, P. Tanabe, Annals of Emergency Medicine
October 2006 (Vol. 48, Issue 4, Page 60) 

5. Impact of Patient Gender on Pain Management Practices in the Emergency Department: A Multi-Center Study, B. Safdar, M. Choiniere, C. Crandall, J. Ducharme, Fosnocht, D.E , P. Homel, P. Tanabe, K.H. Todd
Annals of Emergency Medicine
October 2006 (Vol. 48, Issue 4, Page 121) 

6. Pain in the emergency department: A multicenter study
K. Todd, C. Crandall, M. Choiniere, J. Ducharme, Fosnocht, D.E , P. Homel, P. Tanabe, The Journal of Pain
April 2006 (Vol. 7, Issue 4, Page S61) 

7. Patient Expectations for Pain Relief in the Emergency Department
Fosnocht, D.E, E.R. Swanson, R.L. Stephen, Annals of Emergency Medicine
September 2005 (Vol. 46, Issue 3, Page 49) 

8. History of Severe Pain in Patients Presenting to the Emergency Department
Fosnocht, D.E, E.R. Swanson, R.L. Stephen, Annals of Emergency Medicine
September 2005 (Vol. 46, Issue 3, Page 49) 

9. Comparison of Analgesia in an Academic Emergency Department in 1999 and 2003
Fosnocht, D.E, E.R. Swanson, R.L. Stephen, Annals of Emergency Medicine
September 2005 (Vol. 46, Issue 3, Page 50)