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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