Abstract
Background
Prehospital care (PHC) pain evaluation is an essential patient assessment to be performed
by paramedics. Pain intensity is frequently assessed using Verbal Numerical Rating
Scale (VNRS) or Visual Analog Scale (VAS).
Objective
Our aim was to evaluate the agreement between VNRS and VAS in measuring acute pain
in prehospital setting and to identify the preference among paramedics and patients.
Methods
This was a 3-month cross-sectional study. Convenience sampling was used to enroll
patients with acute pain responded to by the ambulance team. Data from consented patients
were analyzed using Bland-Altman method, Spearman's correlation test, and Cohen's
κ test.
Results
One hundred and thirty-three patients participated in this study (median age 32 years;
72.2% male). The median for pain score at the scene was 7.50 (interquartile range
[IQR]: 5.00) for VAS and 7.00 (IQR: 5.00) for VNRS. The median for pain score on arrival
at the hospital was 7.00 (IQR: 3.10) for VAS and 7.00 (IQR: 4.00) for VNRS. There
was a strong correlation between VNRS and VAS at the scene (r = 0.865; p < 0.001), as well as on arrival at the hospital (r = 0.933; p < 0.001). Kappa coefficient values and Bland-Altman analysis indicates good agreement
between both scales for measuring acute pain. VNRS was the preferred method to measure
acute pain by patients and paramedics.
Conclusions
VAS performs as well as VNRS in assessing acute pain in PHC. VAS and VNRS must not
be used interchangeably to assess acute pain; either method should be used consistently.
Keywords
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Article info
Publication history
Published online: May 25, 2015
Accepted:
February 27,
2015
Received in revised form:
December 24,
2014
Received:
October 14,
2013
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
