Triage, Opiate Prescription Trends

A study presented at the American Academy of Pain Medicine’s 36th Annual Meeting explored the association between emergency room (ER)
triage, level of acuity, and opioid administration. 

Tiffany Matthias, MD, conducted a live electronical medical record review of adult emergency medicine patients at a large academic center from October 1-15, 2017. Acuity was designated by emergency severity index (ESI) triage level at time of triaging ranging from 2 to 5. Patients presenting with chest, abdominal, pelvic, extremity, and head pain were included. 

Of the 739 patients included in the study, 22% received opioids during their ED stay, 69.4% of ESI 2 patients were given opioids, compared with 21.7% in ESI 3, 8.8% in ESI 4. The mean pain score was highest at ESI 3 at 5.8 with average mean pain score ranging from 4.9 to 5.8. 

“Future studies should investigate whether this phenomenon is present in community-based EDs, and whether longer length of stay impacts the likelihood of opiate administration,” concluded Dr Matthias. —Edan Stanley