The Association between Emergency Department Crowding and Analgesia Administration in Acute Abdominal Pain Patients
- 1 July 2009
- journal article
- Published by Wiley in Academic Emergency Medicine
- Vol. 16 (7), 603-608
- https://doi.org/10.1111/j.1553-2712.2009.00441.x
Abstract
The authors assessed the effect of emergency department (ED) crowding on the nontreatment and delay in treatment for analgesia in patients who had acute abdominal pain. This was a secondary analysis of prospectively enrolled nonpregnant adult patients presenting to an urban teaching ED with abdominal pain during a 9-month period. Each patient had four validated crowding measures assigned at triage. Main outcomes were the administration of and delays in time to analgesia. A delay was defined as waiting more than 1 hour for analgesia. Relative risk (RR) regression was used to test the effects of crowding on outcomes. A total of 976 abdominal pain patients (mean [+/-standard deviation] age = 41 [+/-16.6] years; 65% female, 62% black) were enrolled, of whom 649 (67%) received any analgesia. Of those treated, 457 (70%) experienced a delay in analgesia from triage, and 320 (49%) experienced a delay in analgesia after room placement. After adjusting for possible confounders of the ED administration of analgesia (age, sex, race, triage class, severe pain, final diagnosis of either abdominal pain not otherwise specified or gastroenteritis), increasing delays in time to analgesia from triage were independently associated with all four crowding measures, comparing the lowest to the highest quartile of crowding (total patient-care hours RR = 1.54, 95% confidence interval [CI] = 1.32 to 1.80; occupancy rate RR = 1.64, 95% CI = 1.42 to 1.91; inpatient number RR = 1.57, 95% CI = 1.36 to 1.81; and waiting room number RR = 1.53, 95% CI = 1.31 to 1.77). Crowding measures were not associated with the failure to treat with analgesia. Emergency department crowding is associated with delays in analgesic treatment from the time of triage in patients presenting with acute abdominal pain.Keywords
This publication has 37 references indexed in Scilit:
- Emergency Department Crowding and Decreased Quality of Pain CareAcademic Emergency Medicine, 2008
- Effect of Emergency Department Crowding on Time to Antibiotics in Patients Admitted With Community-Acquired PneumoniaAnnals of Emergency Medicine, 2007
- The Impact of Emergency Department Crowding Measures on Time to Antibiotics for Patients With Community-Acquired PneumoniaAnnals of Emergency Medicine, 2007
- Changing Opioid Use for Right Lower Quadrant Abdominal Pain in the Emergency DepartmentAcademic Emergency Medicine, 2005
- Factors Affecting Emergency Department Opioid Administration to Severely Injured PatientsAcademic Emergency Medicine, 2004
- Inadequate analgesia in emergency medicineAnnals of Emergency Medicine, 2004
- Emergency department crowding: Consensus development of potential measuresAnnals of Emergency Medicine, 2003
- Intravenous Morphine for Early Pain Relief in Patients with Acute Abdominal PainAcademic Emergency Medicine, 1996
- Gender-Associated Differences in Emergency Department Pain ManagementAnnals of Emergency Medicine, 1995
- Analgesic use in the emergency departmentAnnals of Emergency Medicine, 1990