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Protocol Emergency Department Unit Practice Manual John Dempsey Hospital Department of Nursing The University of Connecticut Health

th Center PROTOCOL FOR: POLICY: Pain: Care of the Adult Emergency Patient Experiencing Pain

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1. ED patients will have a documented pain assessment in triage according to the Nursing Practice Manual Procedure for: Pain Scale: Use of. 2. Adults presenting to the ED complaining of moderate pain (> 5/10 on numeric scale) secondary to headache, dental pain, first or second degree burn, minor laceration, soft tissue injury, orthopedic injury of the extremities or pain from sickle cell crisis, will be offered pain medication as listed below, if appropriate, while waiting for further treatment. 3. In situations where the patient is unable to verbalize their pain, such as in advanced dementia or in ventilated patients, pain will be assessed using the appropriate alternative scale. 4. ED patients will have a documented pain assessment using pain scale after medication administration.

DESIRED PATIENT OUTCOMES:

1. The patient will receive pain control intervention while awaiting further diagnostic tests/treatments. 2. Pain will be controlled to a level acceptable to the patient.

CLINICAL ASSESSMENT AND CARE:

1. Refer to Nursing Practice Manual Procedure for: Pain Scale: Use of. 2. Identify factors that may influence patients expression of pain or response to interventions (i.e., language barrier) in order to choose appropriate pain assessment tool. 3. Assess pain characteristics in patients own words: a. Location b. Onset c. Duration d. Quality e. Aggravating/alleviating factors f. Intensity (pain scale) 4. Provide patient with comfort measures to reduce pain such as position of comfort, elevation, cold or heat application, routine splint or sling. 5. If pain attributed to conditions in policy statement #2 is reported at > 5/10 and the patient is not vomiting and has not taken any pain medication prior to presentation, offer and administer the following, per MD order: Tylenol 650 mg PO x 1 or Motrin 400 mg PO x 1 (Assess allergies prior to administration) 6. Reassess and document pain level using pain scale within 1 hour after receiving medication administration.

Protocol Emergency Department Unit Practice Manual John Dempsey Hospital Department of Nursing The University of Connecticut Health Center PROTOCOL FOR: REPORTABLE CONDITIONS: DOCUMENTATION: Pain: Care of the Adult Emergency Patient Experiencing Pain

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Any level of pain unacceptable to patient. 1. Document medication administration in the Emergency Department record. 2. Document pain scale assessment and reassessment in the ED record.

APPROVAL:

Emergency Department Standards Committee Nursing Standards Committee Emergency Department Manager & Medical Director 9/03 9/05, 4/08, 9/08, 7/09, 9/10

EFFECTIVE DATE: REVISION DATES: