University of Hertfordshire

Documents

  • A. Niroshan Siriwardena
  • Zahid B. Asghar
  • Bill Lord
  • Helen Pocock
  • Viet-Hai Phung
  • Theresa Foster
  • Julia Williams
  • Helen A. Snooks
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Original languageEnglish
Number of pages6
Pages (from-to)266-271
JournalAmerican Journal of Emergency Medicine
Journal publication dateFeb 2019
Volume37
Issue2
Early online date23 May 2018
DOIs
Publication statusPublished - Feb 2019

Abstract

Objective: We aimed to identify how patient (age, sex, condition) and paramedic factors (sex, role) affected prehospital analgesic administration and pain alleviation. Methods: We used a cross-sectional design with a 7-day retrospective sample of adults aged 18 years or over requiring primary emergency transport to hospital, excluding patients with Glasgow Coma Scale below 13, in two UK ambulance services. Multivariate multilevel regression using Stata 14 analysed factors independently associated with analgesic administration and a clinically meaningful reduction in pain (≥2 points on 0–10 numerical verbal pain score [NVPS]). Results: We included data on 9574 patients. At least two pain scores were recorded in 4773 (49.9%) patients. For all models fitted there was no significant relationship between analgesic administration or pain reduction and sex of the patient or ambulance staff. Reduction in pain (NVPS ≥2) was associated with ambulance crews including at least one paramedic (odds ratio [OR] 1.52, 95% confidence interval [CI] 1.14 to 2.04, p < 0.01), with any recorded pain score and suspected cardiac pain (OR 2.2, 95% CI 1.02 to 4.75). Intravenous morphine administration was also more likely where crews included a paramedic (OR 2.82, 95% CI 1.93 to 4.13, P < 0.01), attending patients aged 51 to 64 years (OR 2.04, 95% CI 1.21 to 3.45, p = 0.01), in moderate to severe (NVPS 4–10) compared with lower levels of pain for any clinical condition group compared with the reference condition. Conclusion: There was no association between patient sex or ambulance staff sex or grade and analgesic administration or pain reduction.

Notes

Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

ID: 14904966