Comparison of patient and caregiver perception of pain from commonly performed accident and emergency services procedures

Objective To compare the perception by naive patients, emergency services clinicians and nurses, of healthcare-induced pain for procedures performed frequently by accident and emergency services. Methods A prospective, three-part anonymous survey, given to caregivers and patients at arrival accident and emergency services. The primary endpoint was the a priori estimated pain score for 10 procedures performed frequently by accident and emergency services. The same estimation was performed with the 'willingness to pay' method (amount allocated a priori to avoid this pain). Results Fifty surveys were analyzed in each group, with a significant difference for pain perception between caregivers and patients concerning four procedures: local anesthesia, fracture or dislocation reduction, dressing change and abscess incision. Caregivers always overestimated pain scores compared with patients. No difference was noted for the remaining five procedures: intravenous line insertion and removal, urethral catheterization, wound suture and nasogastric intubation. Conclusion Caregivers should be aware of the most feared procedures by patients to establish pre-emptive analgesia when possible, inform patients and achieve reassurance. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.