P0283 - Battlefield Auricular Acupressure for Treatment of Pain in the Emergency Department: A Pilot Study

Background: The Joint Commission mandates hospitals to offer non-pharmacologic therapies to treat pain given the current opioid epidemic. Auricular Battlefield Acupuncture (BFA) is utilized in the United States military to treat pain for its rapid onset, safety, and ease of application. Broader usage of BFA with acupuncture needles is limited by certain state regulations. Studies on auricular acupressure with beads suggest achievement of similar pain relief to that with acupuncture needles; however, none have studied BFA with beads. Our study objective is to evaluate the BFA protocol with beads to treat patients with pain in the Emergency Department (ED).

Methods: A retrospective chart review was conducted on a cohort of pediatric and adult patients treated with BFA protocol with beads for pain in an urban ED. Five physicians attended a 1-hour BFA training session and administered BFA during usual ED shifts. Two mm white crystal or gold beads were applied with tape onto specific auricular points according to the BFA protocol. Each bead was pressed for 10 seconds. Data extracted include patient demographics, presenting pain conditions, pre/post acupressure pain scores, time to lowest pain scores and adverse events.

Results: Thirty-two patients received BFA. Sixty-eight percent were female with a mean age of 31± 18 years (range 8-73). Thirty-one had pain scores documented with the following mean + SD pain scores: Pre-treatment 7.55 ± 2 (range 4-10); Post-treatment 3.37 ± 2.6 (range, 0-9). The change in pain score of 4.18 + 2.5 (p < .001; 95% CI, 3.3-5.06) was clinically and statistically significant. Approximately 93% reported a decreased pain score: 72% by > 3 points, 59% had more than 50% pain reduction, with 24% achieving complete pain resolution. Table 1 and Table 2 summarize the data for the adult and pediatric groups separately. Time to lowest pain score was documented correctly for 20 patients; it was achieved by 16% of patients within 15 minutes, 34% within 30 minutes, and 72% within 60 minutes. No adverse events were noted.

Conclusion: This study suggests that BFA protocol with beads may provide a potential non-pharmacologic therapeutic option for acute pain management in the ED.