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.