Sarasota, FL – 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 this value to the patient’s pain scores collected by Wong-Baker face pain rating scale. The study analysis showed a strong positive correlation between decibel level and higher pain score.
Specifically, a decibel level of greater than 90dB (the decibel level of a running lawnmower) was associated with 10/10 pain over 90% of the time. The most common diagnoses found in patients screaming at this decibel level were “acute on chronic back pain,” “kidney stone,” “tooth pain,” and “fibromyalgia exacerbation.”
“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 need 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 90dB receive 1mg of IV dilaudid every 5 minutes until their decibel level drops below 80dB. They recommend increasing the interval by 5 minutes every 10dB until the patient reaches a level of at least 50dB at which point physician discretion would take over.