More Attention Should be Focused on Emergency Room Anxiety

Visits to the emergency department (ED) are usually reserved for life-threatening situations or instances of acute pain or injury. It is no surprise, then, that people who visit the ED may experience elevated levels of anxiety as a result of the situation that prompts the visit. But how does anxiety affect pain management and treatment in the ED setting? Philip C. Craven of the Centers for Infectious Diseases in Atlanta and Infections Limited in Tacoma, Washington wanted to explore this question further.

In a recent study, Craven examined data from over 10,000 patients who visited the ED over a 10 year period. He found that approximately 25% reported no anxiety, 25% mild anxiety, 25% moderate and 25% severe anxiety during their visits. In other words, about 75% of the people who visited the ED had some anxiety. And even though the records revealed that over half of the patients were willing to take something to help relieve their anxiety, only 1% of them received anxiety medication.

Those with high levels of anxiety had more pain and demanded more pain medication than those with lower levels of anxiety. Also, those with the highest levels of anxiety reported lower levels of pain management satisfaction and were more likely to leave the ED with persistent levels of high anxiety and pain.

Craven believes these findings demonstrate the need for better attention to the mental health of patients visiting the ED. When people go to the ED in pain, assessing the mental health and, in particular, the anxiety of the patients, may help doctors deliver the most effective and useful treatment.

Often, anxiety is the result of the pain or the visit, and not merely a clinical condition such as obsessive compulsive behavior, panic or social anxiety. If this is the case with the majority of patients entering the ED, determining ways to reduce anxiety could provide several benefits. Craven added, “Increased attention to anxiety in ED patients may result in improved treatment of pain and overall patient satisfaction.”

Craven, P., Orhan, C., and Madsen, T. (2013). Patient Anxiety may Influence the Efficacy of ED Pain Management. The American Journal of Emergency Medicine 31.2 (2013): 313-8. ProQuest. Web.

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The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Katy


    May 28th, 2013 at 10:34 PM

    I get very anxious when I’m ill!Its the suffering,the missed work and financial and other obligations that come to mind when I’m unable to do anything except for take care of myself.And requiring others’ help also causes anxiety.This would only be more elevated in those in emergency visits.They really should look at this more seriously and help these people.

  • racine r

    racine r

    May 29th, 2013 at 3:47 AM

    No what the the ER in my city hospital needs to focus on is a better way to assess which patients are true emergencies and which could be filtered off to an urgent care center or something like that. I mean you go and wait for hours to be seen and then you are still waiting hours later with no end to it in sight. I would have to think that after all of this time of operating an ER the people in charge would have a better idea of how most of the patients should be handled. If not then maybe it’s time to call in some outside consultants. The wait is always the biggest source of anxiety that I see there, so solve this problem and it’s like killing a couple of birds with one stone.

  • NED


    May 29th, 2013 at 9:30 AM


  • Spy Fly

    Spy Fly

    May 30th, 2013 at 12:34 AM

    Physical and anxiety can be a lethal combination.I was extremely anxious after a minor road accident.And although things turned out fine what happened that day still sends shivers down my spine and I’m sure it made the pain worse.

  • Logan


    May 30th, 2013 at 3:57 AM

    Just get the sickest patients in and out and then worry aboutt he small things.
    here’s a thought- maybe if we had a healthcare system that actually worked then there wouldn’t be so many people who feel that they have to rely on the emergency room to be theri primary care physician.
    They know that the ER can’t turn them away so they come there with even the small things, and it is these kinds of vists that them log jam it for everyone else.

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