Pain in emergency units: correlation with risk classification categories.
Wandressa Letícia Viveiros, Meiry Fernanda Pinto Okuno, Cássia Regina Vancini Campanharo and 3 others
PMID 30462784WHAT IT FOUND
Emergency triage categories did not reliably match reported pain intensity.
Patients classified as most urgent (red) frequently reported no pain, while those in lower urgency categories (green, yellow, orange) often reported severe pain. Triage color alone is an unreliable proxy for pain presence or severity.
Key findings
01Patients classified in the red (immediate care) category had a higher percentage of absence of pain (53.6%), whereas patients classified as green, yellow and orange had severe pain.
02Most patients (37.6%) reported no pain, while 25.9% reported moderate pain and 24.4% reported severe pain.
03Pain intensity was significantly associated with medical specialty: orthopedics patients had the highest percentage of severe pain (38.8%), while psychiatry patients had the highest percentage of absence of pain (90.5%).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Single-center study, limiting generalizability. Retrospective analysis of medical records, which were often incomplete or illegible. Pain assessment was subjective and relied on patient self-report at triage, which can be impaired by altered mental status or anxiety. The triage protocol was institution-specific and adapted, making comparisons with other studies difficult.
The easy way to misread this
Do not assume that patients in the 'Red' (most urgent) triage category are in severe pain, or that patients in 'Green' or 'Yellow' categories are comfortable. The study found that over half of the most urgent patients reported no pain, while a significant portion of less urgent patients reported severe pain. Pain assessment must be a separate, explicit step in the nursing triage process.