INTRODUCTION Pain is the most frequent presenting complaint in patients consulting or admitted to the emergency department (ED). Thus, its acute management is often done by physicians working in the ED. These clinicians are often general practitioners and not emergency medicine physicians in resource-poor settings. Hence, a mastery of pain management by these physicians may be important in relieving acute pain. We aimed to assess the knowledge, to determine the attitudes and practices of physicians in the management of pain in EDs of Cameroon. METHODS We carried out a prospective cross-sectional study over 4 months in the year 2018. We enrolled all consenting physicians who were neither emergency medicine doctors nor anesthesiologists working at the EDs of five tertiary hospitals of Cameroon. Using a validated and pretested structured questionnaire, data on the knowledge, attitudes, and practices of acute pain management at the ED by these clinicians were studied. We used an externally validated score to assess the knowledge as either poor, insufficient, moderate or good. RESULTS A total of 58 physicians were included; 18 interns or residents and 39 general practitioners. Their mean age was 28.6 ± 3 years and their average number of years of practice was 2.9 years. The level of knowledge was rated "poor" in 77.6% of physicians. Being a general practitioner was significantly associated with a poor level of knowledge (p = 0.02; OR = 5.1). We found a negative and significant correlation between knowledge and years of practice (p = 0.04; r2 = 0.06). More than three-quarter (82.8%) of participants used a pain scale to evaluate the severity of pain. The most used scale was the Visual Analog Scale (56.9%). The most frequently used analgesic was paracetamol (98.3%), although only 3.5% of physicians correctly knew its half-life, delay of onset of action and duration of action. CONCLUSION These findings suggest that physicians in EDs of Cameroon have poor knowledge and suboptimal practices in pain management. General practice and a greater number of professional experience seemed to favour these attitudes. Overall, there is an urgent need for refresher courses in acute pain management for physicians working in these resource-limited EDs.

中文翻译：

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喀麦隆医师关于急诊科急性疼痛管理的知识，态度和做法：多中心横断面研究。

简介疼痛是咨询或入院急诊科（ED）的患者中最常见的主诉。因此，其急诊管理通常由在急诊室工作的医生来完成。这些临床医生通常是资源匮乏地区的全科医生，而不是急诊医学医师。因此，由这些医生掌握的疼痛管理对缓解急性疼痛可能很重要。我们旨在评估知识，确定医师在喀麦隆急诊室疼痛管理中的态度和做法。方法我们在2018年进行了为期4个月的前瞻性横断面研究。我们招募了所有在喀麦隆五家三级医院的急诊科就诊的既不是急诊医学医师也不是麻醉医师的医师。使用经过验证和预先测试的结构化问卷，对这些临床医生在急诊室进行的急性疼痛管理的知识，态度和实践进行了研究。我们使用了外部验证的分数来评估知识的程度，包括差，不足，中等或良好。结果总共包括58位医生；18位实习生或居民和39位全科医生。他们的平均年龄为28.6±3岁，平均从业年限为2.9年。在77.6％的医师中，知识水平被评为“差”。作为一名全科医生与知识水平低下显着相关（p = 0.02； OR = 5.1）。我们发现知识与实践年限之间存在负显着相关性（p = 0.04； r2 = 0.06）。超过四分之三（82。8％的参与者使用疼痛量表评估疼痛的严重程度。最常用的量表是视觉模拟量表（56.9％）。最常用的镇痛药是扑热息痛（98.3％），尽管只有3.5％的医生正确地知道其半衰期，起效延迟和作用持续时间。结论这些发现表明，喀麦隆急诊科医师对疼痛的管理知识和实践欠佳。一般实践和更多的专业经验似乎都支持这些态度。总体而言，迫切需要为在这些资源有限的急诊科工作的医生提供急性疼痛管理的进修课程。5％的医生正确地知道其半衰期，起效延迟和作用持续时间。结论这些发现表明，喀麦隆急诊科医师对疼痛的管理知识和实践欠佳。一般实践和更多的专业经验似乎都支持这些态度。总体而言，迫切需要为在这些资源有限的急诊科工作的医生提供急性疼痛管理的进修课程。5％的医生正确地知道其半衰期，起效延迟和作用持续时间。结论这些发现表明，喀麦隆急诊科医师对疼痛的管理知识和实践欠佳。一般实践和更多的专业经验似乎都支持这些态度。总体而言，迫切需要为在这些资源有限的急诊科工作的医生提供急性疼痛管理的进修课程。