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A primary focus of emergency department care is assessing and alleviating pain. To study the effect of ED overcrowding on the quality of pain care, researchers reviewed electronic charts for 1068 visits to an urban academic ED during the months of July and December 2005 by adult patients (age, ≥18) who presented with a chief complaint of pain and had a final primary ED diagnosis of a painful condition.
Total ED census and number of boarders were directly correlated with longer times to assessment of pain, ordering of analgesic medications, and administration of analgesics. Adjusted multivariate analysis showed that patients waited up to 43 minutes longer to receive pain medication during times of high ED census (>50th percentile) than during…