TITLE:
Acute Pain Management in the Emergency Department of Essos Hospital Centre: A Leading-Edge Care Model in a High-Reference Hospital in Central Africa
AUTHORS:
Serge Vivier Nga Nomo, Charles Emmanuel Toussaint Binam Bikoi, Aristide Gilles Kuitchet Njeunji, Cristella Raissa Iroume Bifouna, Amos Kounde, Bonaventure Jemea, Fidèle Binam
KEYWORDS:
Acute Pain, Pain Management, Emergency Department, Sub-Saharan Africa
JOURNAL NAME:
Open Journal of Emergency Medicine,
Vol.13 No.1,
March
7,
2025
ABSTRACT: Background: Acute pain is a subjective experience that is frequently underappreciated in emergency services, particularly in sub-Saharan Africa, where resources and treatment protocols may be limited. This study seeks to examine current practices in the assessment and management of acute pain, identify existing gaps, and offer recommendations to enhance patient care. Methods: This was a prospective observational study conducted in the emergency department of Essos Hospital from 1 January to 31 March 2024. All adult patients (aged 18 and over) presenting with acute pain, regardless of the underlying cause, were included. Exclusion criteria consisted of patients unable to provide informed consent, those with cognitive impairments, or those with a history of opioid dependence. Data were collected via a questionnaire and a review of medical records. The variables studied included: the type of pain (traumatic or non-traumatic), the onset and location of pain, pain assessment at admission using the Simple Verbal Scale (SVS), the analgesic administered, the SVS score one hour later, and the duration of analgesic prescription. The primary outcome measure was an SVS score of ≤1, one hour after the administration of analgesics. Results: A total of 138 patients were included from 279 admissions. The mean age was 39.3 years (standard deviation: 18.8), with a male-to-female ratio of 1.3. Traumatic pain was present in 52.2% of cases. At the time of admission, 7.3% of patients reported severe pain (SVS = 3), while 92.7% reported very severe pain (SVS = 4). The average time to the administration of the first analgesic was 32.8 ± 15.9 minutes. In 89.1% of cases (n = 123), the onset of pain occurred within the preceding 24 hours. The mean SVS score was 2.6 one hour after the first analgesic was administered. The most commonly administered analgesic was tramadol (43.9%), followed by paracetamol (30.4%). Conclusion: Severe pain affects nearly half of the patients presenting to the emergency department at Essos Hospital. Effectively managing this pain remains a significant challenge. Enhancing the management of acute pain continues to be a major concern for emergency services across sub-Saharan Africa.