Pain in the Emergency Room

Abstract

Abstract Pain and vulnerability frequently coincide during visits to the emergency department (ED). Approximately 75% of ED visits involve the management of pain, with many patients also reporting chronic pain conditions. At the same time, a complex interplay of patient, provider, and systemic factors can lead to individuals experiencing vulnerability during an ED visit. Understanding the variables that contribute to pain and vulnerability is necessary to ensure that patients have access to evidence-based and equitable care. Some interventions can be deployed at the individual provider level to address these issues, but truly solving problems of inequity, vulnerability, and access to care will require a systematic approach in health care and social interventions that are outside the control of individual patients and health care providers at the time of an ED visit. This chapter provides an overview of the impact of pain and vulnerability on patient outcomes, underlying sources of vulnerability, and proposes interventions aimed at reducing vulnerability and harm while improving equitable access to care. Providing the best possible care to a patient with a goal of improving health rather than simply mitigating disease involves health care providers and the system in which they operate taking a holistic approach that includes recognition and palliation of elements that contribute to a patient’s vulnerability.