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Exploratory cross-sectional study of factors associated with pre-hospital management of pain
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Siriwardena, A Niroshan, Shaw, Deborah and Bouliotis, Georgios (2010) Exploratory cross-sectional study of factors associated with pre-hospital management of pain. Journal of Evaluation in Clinical Practice, 16 (6). pp. 1269-75. doi:10.1111/j.1365-2753.2009.01312.x ISSN 1356-1294.
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Official URL: https://doi.org/10.1111/j.1365-2753.2009.01312.x
Abstract
Rationale, aims and objectives: Improving pain management is important in pre‐hospital settings. We aimed to investigate how pain was managed in pre‐hospital suspected acute myocardial infarction (AMI) or fracture and how this could be improved.
Method: We conducted a cross‐sectional study in Lincolnshire using recorded suspected AMI and fracture between April 2005 and March 2006. Outcomes included pain assessment, improvement in pain scores and administration of Entonox, opiates or GTN (in AMI).
Results: We accessed 3654 patients with suspected AMI or fracture. Pain was assessed in over three quarters of patients but analgesics administered in under two‐fifths. Assessment was more likely in patients with suspected AMI (OR 2.05, 95% CI [1.70, 2.47]), and who were alert (OR 3.55, 95% CI [2.32, 5.43]). Entonox was less likely to be administered for suspected AMI (OR 0.11, 95% CI [0.087, 0.15]) or by paramedic crews (OR 0.56, 95% CI [0.45, 0.68]) but more likely to be given when pain had been assessed (OR 3.54, 95% CI [2.77, 4.52]). Opiates were more likely to be prescribed for suspected AMI (OR 1.30, 95% CI [1.07, 1.57]), in alert patients (OR 1.35, 95% CI [0.71, 2.56]) assessed for pain (OR 2.20, 95% CI [1.73, 2.80]) by paramedic crews.
Conclusions: This exploratory study showed shortfalls in assessment and treatment of pain, but also demonstrated that assessment of pain was associated with more effective treatment. Further research is needed to understand barriers to pre‐hospital pain management and investigate mechanisms to overcome these.
| Item Type: | Journal Article | ||||||
|---|---|---|---|---|---|---|---|
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | Journal of Evaluation in Clinical Practice | ||||||
| Publisher: | Wiley-Blackwell Publishing Ltd. | ||||||
| ISSN: | 1356-1294 | ||||||
| Official Date: | December 2010 | ||||||
| Dates: |
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| Volume: | 16 | ||||||
| Number: | 6 | ||||||
| Page Range: | pp. 1269-75 | ||||||
| DOI: | 10.1111/j.1365-2753.2009.01312.x | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Restricted or Subscription Access |
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