EMERGENCY MEDICINE Open Journal http://dx.doi.org/10.17140/EMOJ-3-e003 Emerg Med Open J ISSN 2379-4046 Time to Rewrite Assessment and Documentation of Acute Pain in the Emergency Setting Özgür Karcioglu, MD * Department of Emergency Medicine, University of Health Sciences, Istanbul Education and Research Hospital, 34098 Fatih, Istanbul, Turkey * Corresponding author Özgür Karcioglu, MD Department of Emergency Medicine University of Health Sciences Istanbul Education and Research Hospital, 34098 Fatih Istanbul, Turkey Tel. +90-505-5252399 E-mail: okarcioglu@gmail.com Article History Received: September 26 th , 2017 Accepted: October 4 th , 2017 Published: October 5 th , 2017 Citation Karcioglu Ö. Time to rewrite assess- ment and documentation of acute pain in the emergency setting. Emerg Med Open J. 2017; 3(2): e1-e3. doi: 10.17140/EMOJ-3-e003 Copyright ©2017 Karcioglu Ö. This is an open access article distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Volume 3 : Issue 2 Article Ref. #: 1000EMOJ3e003 Editorial Page e1 As a subjective and a unique individual experience, acute pain is one of the most common chief complaints reported by a majority of patients who are admitted to the emergency department (ED), while its perception and expression have great variations between countries. Acutely painful conditions are under evaluated and under treated in the ED, sugges- ting that ED staff need more education and training about the management of acute pain. One important step in relieving pain is to assess its presence and degree. 1 The effective management of acute pain in the ED requires appropriate assessment of the pain based on the patient’s per- ception of pain using a validated pain scale. Additionally, reassessment of pain is essential to determine the effect of treatment. 2 The International Association for the Study of Pain (IASP) has described pain as ‘an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage’. Within the last two decades, pain management policies of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) have become standard and the addition of pain as the “ifth” vital sign was noted in the context of initial assessment. Although, there seems to be a consensus among medical disciplines to address its importance, one cannot yet claim that all healthcare personnel behave within standards in every real life situations worl- dwide. Pain is what the patient states it is. On the other hand, a myriad of psychological, soci- ocultural, temporal and situational variables affects how people perceive and express their pain. Age, sex, ethnicity, associated psychiatric problems and socio-economic status of the patient are some of the factors which affect the magnitude and quality of an individual expresses his/ her complaints. Two decades ago, researchers pointed out that female patients tend to report the severity of pain higher than males did and therefore received more pain medications. Thus, the painful experience becomes a unique phenomenon for each patient, thereby necessitating the use of versatile tools of assessment in the clinical practice. The assessment of pain in the acute situation involves the site, quality and severity of the discomfort. Although, some authors advocated the use of physiological parameters to eva- luate the properties of pain, they are more useful to verify a clinical impression. Physiological clues such as tachycardia, hypertension or restlessness may help determine the requirement for pain management in intubated or excitated/incoherent patients. Decreased tidal volume, vital capacity, and in turn, alveolar hypoventilation may result from abdominal and thoracic pain. Increased systemic vascular resistance and sympathetic tone resulting from pain may mask hypovolemia, thus may preclude adequate luid resuscitation. PAIN SCORES AND DOCUMENTATION OF PAIN One deinition of measurement is ‘the assignment of numbers to objects or events to represent