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Background <p>Pain is one of the primary reasons for patients to seek care in emergency departments. Although various guidelines mandate systematic pain assessment and management in emergency settings, previous studies have demonstrated substantial heterogeneity in practice. The aim of this study was to analyze the current state of pain assessment and treatment in German emergency departments using a&#xa0;quantitative online survey.</p> Materials and methods <p>A&#xa0;quantitative online survey was conducted among five professional groups involved in emergency care. Recruitment took place at the 20th&#xa0;DGINA congress as well as through professional mailing lists, online platforms, and conference presentations (08&#xa0;May–27&#xa0;July&#xa0;2025). The questionnaire included qualification- and profession-specific adaptations.</p> Results <p>A&#xa0;total of 879 complete questionnaires from all levels of emergency care and all professional groups were analyzed. Initial patient assessment was predominantly performed by nursing staff (85.4–90.8%). For pain assessment, the numerical rating scale was most commonly used in adults (87.2%), while children were more frequently assessed using the smiley (emoji-based) analog scale (29.9%). Standard operating procedures (SOP) for pain management were implemented in 50.6% of emergency departments, with notable discrepancies between reports from heads of departments and other professional groups. In 91.2% of departments, pain treatment was incorporated into the initial assessment, mainly through standardized delegation. Authorized analgesics primarily included paracetamol, ibuprofen, and metamizole; opioids were rarely delegated in a&#xa0;standardized manner. Only about 41.1% of cases had legally compliant informed consent, e.g., for medications like metamizole. Overall, implementation was heterogeneous, and satisfaction with pain management was moderate.</p> Conclusion <p>Pain management in German emergency departments remains inconsistent. To ensure rapid, effective, and safe analgesia across all settings, key measures include targeted use of age-appropriate assessment tools, implementation and training of standardized SOP, quality-assured delegation practices, and legally compliant patient education.</p>

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Ist-Analyse der Schmerztherapie in deutschen Notaufnahmen – SOP-Inhalte und Delegationsstrukturen

  • 期刊论文

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  • 发表日期：

    2026年5月19日

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  • Steffen Nüsken,
  • Michael Bernhard,
  • Michael Dommasch,
  • Andreas Hüfner,
  • Patrick Dormann

摘要

Background

Pain is one of the primary reasons for patients to seek care in emergency departments. Although various guidelines mandate systematic pain assessment and management in emergency settings, previous studies have demonstrated substantial heterogeneity in practice. The aim of this study was to analyze the current state of pain assessment and treatment in German emergency departments using a quantitative online survey.

Materials and methods

A quantitative online survey was conducted among five professional groups involved in emergency care. Recruitment took place at the 20th DGINA congress as well as through professional mailing lists, online platforms, and conference presentations (08 May–27 July 2025). The questionnaire included qualification- and profession-specific adaptations.

Results

A total of 879 complete questionnaires from all levels of emergency care and all professional groups were analyzed. Initial patient assessment was predominantly performed by nursing staff (85.4–90.8%). For pain assessment, the numerical rating scale was most commonly used in adults (87.2%), while children were more frequently assessed using the smiley (emoji-based) analog scale (29.9%). Standard operating procedures (SOP) for pain management were implemented in 50.6% of emergency departments, with notable discrepancies between reports from heads of departments and other professional groups. In 91.2% of departments, pain treatment was incorporated into the initial assessment, mainly through standardized delegation. Authorized analgesics primarily included paracetamol, ibuprofen, and metamizole; opioids were rarely delegated in a standardized manner. Only about 41.1% of cases had legally compliant informed consent, e.g., for medications like metamizole. Overall, implementation was heterogeneous, and satisfaction with pain management was moderate.

Conclusion

Pain management in German emergency departments remains inconsistent. To ensure rapid, effective, and safe analgesia across all settings, key measures include targeted use of age-appropriate assessment tools, implementation and training of standardized SOP, quality-assured delegation practices, and legally compliant patient education.