Analgesic administration to patients with an acute abdomen: A survey of emergency medicine physicians

The objective of this study was to examine current practice patterns of ana lgesia administration among emergency physicians (EPs) when caring for a pa tient with an acute abdomen, Grass sectional data were acquired by a survey mailed in October 1997 to 1,000 American College of Emergency Physicians ( ACEP) members from a purchased ACEP mailing list which contained 1,000 rand omized ACEP members. A repeat survey was sent to nonresponders 2 months lat er and a random subset of recurrent nonresponders were telephoned, The ques tionnaire focused on physician demographics, practice patterns, and factors which influenced physician decision of when and whether to administer pain medication, specifically opiates, to patients with an acute abdomen. Forty four percent of surveys were returned. Seventy-seven percent of respondent s were men with an average of 10 years of experience, Fifty-seven percent w ere residency trained in emergency medicine, Although eighty-five percent f elt that the conservative administration of pain medication did not change important physical findings on the physical examination, 76% choose not to give an opiate analgesic until after the examination by a surgeon. Twenty-f ive percent of patients did not receive any pain medication in the departme nt. In conclusion, although EPs report that the judicious administration of pain medication does not mask important examination findings, the majority wait until after the surgeon has evaluated the patient to deliver analgesi cs, (Am J Emerg Med 2000;18:250-253. Copyright (C) 2000 by W.B. Saunders Co mpany).