• Agnes Ricard-Hibon, Jean-Louis Ducassé, Philippe Ravaud, Chantal Wood, Eric Viel, Marcel Chauvin, Fabrice Brunet, and Gérard Bleichner.
• Department of Anaesthesiology and Intensive Care, Beaujon University Hospital, Clichy, France. agnes.ricard@bjn.ap-hop-paris.fr
• Eur J Emerg Med. 2004 Aug 1;11(4):198-203.

ObjectiveThis national survey was carried out to evaluate the quality programme for acute pain management in the emergency department (ED) and in pre-hospital emergency medical services (EMS).MethodsTwo types of questionnaires were sent to the chief consultant and the chief nurse of all ED and EMS. Data collected were: the type of structure, quality programme organization, acute pain management, and the training needs to initiate a pain quality programme.ResultsA total of 363 questionnaires were recorded (198 from chief consultants) with 98% of questionnaires being usable. A pain management committee existed in 71% of cases, a quality committee in 83%. A complete quality control procedure existed in 53% of units. An audit on pain management was carried out in only 23% of cases. Training in quality was performed for 64% of physicians and 68% of nurses. Training specifically for pain management was carried out for physicians in 56% of cases and for nurses in 68% of cases. Pain therapeutics protocols existed in 69% of cases. Pain intensity was evaluated 'systematically or often' in 64% at the beginning of patient management, and in 56% at the end of patient management. The staff was 'not very motivated' for a pain management quality programme in less than 3% of responses. A total of 61% of chief consultants and 58% of chief nurses requested advice.ConclusionMost ED and EMS units seem to master the quality control programme methodology. Units are highly motivated to initiate a quality control programme on pain. Nevertheless, its implementation could benefit from some external support.

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