The objective of this study was to examine current practice patterns of
analgesia administration among emergency physicians (EPs) when caring for a patient with an
acute abdomen. Cross sectional data were acquired by a survey mailed in October 1997 to 1,000 American College of Emergency Physicians (
ACEP) members from a purchased
ACEP mailing list which contained 1,000 randomized
ACEP members. A repeat survey was sent to nonresponders 2 months later and a random subset of recurrent nonresponders were telephoned. The questionnaire focused on physician demographics, practice patterns, and factors which influenced physician decision of when and whether to administer
pain medication, specifically
opiates, to patients with an
acute abdomen. Forty-four percent of surveys were returned. Seventy-seven percent of respondents were men with an average of 10 years of experience. Fifty-seven percent were residency trained in emergency medicine. Although eighty-five percent felt that the conservative administration of
pain medication did not change important physical findings on the physical examination, 76% choose not to give an
opiate analgesic until after the examination by a surgeon. Twenty-five percent of patients did not receive any
pain medication in the department. In conclusion, although EPs report that the judicious administration of
pain medication does not mask important examination findings, the majority wait until after the surgeon has evaluated the patient to deliver
analgesics.