• Thomas J Luger, Wolfgang Lederer, Michael Gassner, Alexander Löckinger, Hanno Ulmer, and Ingo H Lorenz.
• Department of Anesthesiology and Critical Care Medicine, University of Innsbruck, Austria.
• Acad Emerg Med. 2003 Jun 1; 10 (6): 627-32.

ObjectivesTo evaluate the quality of pain assessment by emergency medical services (EMS) in out-of-hospital emergencies.MethodsA prospective study was conducted on a convenience sample of patients during a one-year observation period. Pain ratings assessed by emergency patients were documented at three different intervals during the emergency call, and compared with concomitant assessments by EMS providers. A visual analog scale (VAS) and a verbal pain scale (VPS) were used for pain assessment. Repeated-measures ANOVA and Dunnett's t-test were used for data analysis.ResultsFifty-one out of 70 eligible patients met inclusion criteria. In most emergency patients the intensity of pain was underestimated by EMS, especially when pain was severe (p = 0.0001). During the course of transport, both pain and pain assessment by EMS improved significantly (p = 0.0001). The VAS and VPS were significantly correlated (p = 0.0001).ConclusionsEMS providers significantly underestimate their patients' pain severity. EMS providers should be more attentive to their patients' complaints and comfort.

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