screaming in ED

ED Study Links Volume of Screaming to Patient’s Level of Pain

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SAN ANTONIO, TX – In a landmark study published in this month’s Annals of Emergency Medicine, researchers from an emergency department in Sarasota, Florida have found evidence of a link between the decibel level of a patient’s screaming or yelling, their level of pain, and their pain medication requirements.

The study design involved nurses carrying a decibel meter on their shirt when entering a patient’s room.  The maximum decibel level during the triage encounter was recorded and the study authors compared their value to the patients’ scores collected by Wong-Baker FACES Pain Scale.  The study analysis showed a strong positive correlation between decibel level and higher pain score.

Specifically, a decibel level of greater than 90 dB (the decibel of a running lawnmower) was associated with 10/10 pain over 90% of the time.  “This study proves what we have all been thinking,” says lead study author Pablo Gutierrez.  “When patients come in the department screaming for their pain medicine, they have significant pain medication requirements and needed to be treated accordingly.”

The study authors recommend an aggressive nurse-driven pain management protocol, suggesting patients yelling with a decibel level of greater than 90 dB receive 1 mg of Dilaudid every 5 minutes until their decibel level drops below 80 dB.  They recommend increasing the interval by 5 minutes every 10 dB until the patient reaches a level of at least 65 dB at which point physician discretion would take over.

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