Medical Journal of the Islamic Republic Of Iran

other A Systematic Review of Pain Assessment Tools in Prehospital Emergency Care: Evidence from Observational Studies Emergency Medicine Emergency Medicine Review Article Review Article   Background: In the prehospital setting, pain assessment and documentation are often insufficient due to time constraints and high workload. Although validated tools such as the Numerical Rating Scale (NRS), Visual Analogue Scale (VAS), and Verbal Rating Scale (VRS) exist for rapid pain assessment, their use in emergency medical services (EMS) remains unclear.    Methods: This systematic review was conducted according to the PRISMA 2020 guidelines. A comprehensive search of PubMed, Web of Science, Scopus, and Google Scholar databases was performed for observational studies conducted in prehospital emergency settings, including both trauma and mixed patient populations reporting pain assessment practices.    Results: Of the 1,834 identified articles, 8 studies in which pain intensity was measured using standard instruments such as NRS, VAS, or VRS were eligible for inclusion. The results showed that the documentation and assessment of pain in the prehospital setting were performed in only 22.5% to 46.7% of patients, indicating a generally low frequency of pain evaluation before hospital admission. Across the included observational studies, EMS-related pain management interventions were reported to be associated with reductions in pain intensity; however, due to methodological heterogeneity and the absence of quantitative synthesis, the magnitude of these changes could not be reliably estimated.    Conclusion: Pain recording and assessment in the prehospital setting are below recommended standards, and only a limited proportion of patients are systematically monitored. This deficiency can lead to inadequate decision-making in pain management. Strengthening the training of EMS personnel for recording pain is essential to improve the quality of care.   Pain Assessment Tools, Emergency Care, emergency medical services, Visual Analogue Scale, pain 545 553 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1-1130&slc_lang=other&sid=1 Seyed Mohammad Hosseini Kasnavieh mhoseini1346@gmail.com 200319475328460098332 200319475328460098332 No Department of Emergency Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Maryam Milanifard maryammilani837@yahoo.com 200319475328460098333 200319475328460098333 No Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran Mohsen Sedighi Sedighi.mo@iums.ac.ir 200319475328460098334 200319475328460098334 No Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran Roxana Hessam hessamroxana@yahoo.com 200319475328460098335 200319475328460098335 Yes Department of Emergency Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran