EMS Analgesia: A Comparison of the Paramedic's Treatment for Painful Traumatic Conditions versus Painful Medical Conditions

2.50
Hdl Handle:
http://hdl.handle.net/10755/162472
Type:
Presentation
Title:
EMS Analgesia: A Comparison of the Paramedic's Treatment for Painful Traumatic Conditions versus Painful Medical Conditions
Abstract:
EMS Analgesia: A Comparison of the Paramedic's Treatment for Painful Traumatic Conditions versus Painful Medical Conditions
Conference Sponsor:Emergency Nurses Association
Conference Year:2008
Author:Goldstein, Mark, RN, MSN, EMT-IP I/C
P.I. Institution Name:William Beaumont Hospital
Title:EMS Coordinator
Contact Address:3601 W. 13 Mile Road, Royal Oak, MI, 48073, USA
Contact Telephone:(248) 898-2386
Co-Authors:Adam Dezure, BS and Robert Swor, DO, FACEP
[Research Presentation] Introduction: A Wealth of EMS literature has documented low rates of analgesia for injured EMS patients. EMS systems have focused education and policy changes to increase analgesic use.

Purpose: We wished to describe the frequency of EMS and emergency department (ED) analgesia administration for a painful traumatic injury (hip fracture) and a painful medical condition (renal colic) and describe factors associated with the administration of analgesia by EMS.

Design: A retrospective study.

Setting: Adults (>age16) transported by EMS to a single teaching suburban Level 1 trauma center with an ED diagnosis of hip fracture or kidney stone.

Sample: All cases were identified by a hospital administrative database which allowed cross-linking of EMS transport and final Emergency Department diagnosis. The study period was six months (7/04-12/04). 110 patients met inclusion criteria, with 21 excluded because of no runsheets.

Methodology: Data elements collected included ED and EMS pain severity, EMS response and treatment characteristics, and EMS and ED pain prescription treatment. Analgesia is defined as administration of any parenteral narcotic. Time intervals to analgesia from EMS and ED arrival were calculated. Patients with multiple trauma or in whom EMS runsheets could not be identified were excluded.

Results: Subjects were predominantly female (61%) and elderly [mean age 80 (range 16-99) years]. Of these, 73 (90.1 %) sustained a hip fractures and 9 (9.9%) had kidney stones. Overall, 81.0% received ED analgesia and 11.4% received prehospital analgesia. Kidney stone patients had a greater pain severity than hip fracture patients (mean pain score 8.7 +/- 3.4 vs. 6.5 +/-2.1, p=0.049). Few patients (16.1%) with hip fracture and no patients with kidney stone received prehospital analgesia. A majority of patients with hip fracture (57.1%) and kidney stone (66.7%) had severe pain (> 7/10) on ED arrival. Patient age or pain severity was not significantly associated with receipt of EMS analgesia. Hip fracture patients who received prehospital analgesia received it 115 minutes sooner (range 22-280 minutes) than patients that waited for ED analgesia.

Conclusion: Despite substantial educational and policy efforts focused on EMS providers, few patients received EMS analgesia, suggesting that low rates of analgesia may be due to patient as well as provider factors.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEMS Analgesia: A Comparison of the Paramedic's Treatment for Painful Traumatic Conditions versus Painful Medical Conditionsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162472-
dc.description.abstract<table><tr><td colspan="2" class="item-title">EMS Analgesia: A Comparison of the Paramedic's Treatment for Painful Traumatic Conditions versus Painful Medical Conditions</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2008</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Goldstein, Mark, RN, MSN, EMT-IP I/C</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">William Beaumont Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">EMS Coordinator</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">3601 W. 13 Mile Road, Royal Oak, MI, 48073, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(248) 898-2386</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Markgoldstein1967@yahoo.com</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Adam Dezure, BS and Robert Swor, DO, FACEP</td></tr><tr><td colspan="2" class="item-abstract">[Research Presentation] Introduction: A Wealth of EMS literature has documented low rates of analgesia for injured EMS patients. EMS systems have focused education and policy changes to increase analgesic use. <br/><br/>Purpose: We wished to describe the frequency of EMS and emergency department (ED) analgesia administration for a painful traumatic injury (hip fracture) and a painful medical condition (renal colic) and describe factors associated with the administration of analgesia by EMS. <br/><br/>Design: A retrospective study.<br/><br/>Setting: Adults (&gt;age16) transported by EMS to a single teaching suburban Level 1 trauma center with an ED diagnosis of hip fracture or kidney stone. <br/><br/>Sample: All cases were identified by a hospital administrative database which allowed cross-linking of EMS transport and final Emergency Department diagnosis. The study period was six months (7/04-12/04). 110 patients met inclusion criteria, with 21 excluded because of no runsheets. <br/><br/>Methodology: Data elements collected included ED and EMS pain severity, EMS response and treatment characteristics, and EMS and ED pain prescription treatment. Analgesia is defined as administration of any parenteral narcotic. Time intervals to analgesia from EMS and ED arrival were calculated. Patients with multiple trauma or in whom EMS runsheets could not be identified were excluded. <br/><br/>Results: Subjects were predominantly female (61%) and elderly [mean age 80 (range 16-99) years]. Of these, 73 (90.1 %) sustained a hip fractures and 9 (9.9%) had kidney stones. Overall, 81.0% received ED analgesia and 11.4% received prehospital analgesia. Kidney stone patients had a greater pain severity than hip fracture patients (mean pain score 8.7 +/- 3.4 vs. 6.5 +/-2.1, p=0.049). Few patients (16.1%) with hip fracture and no patients with kidney stone received prehospital analgesia. A majority of patients with hip fracture (57.1%) and kidney stone (66.7%) had severe pain (&gt; 7/10) on ED arrival. Patient age or pain severity was not significantly associated with receipt of EMS analgesia. Hip fracture patients who received prehospital analgesia received it 115 minutes sooner (range 22-280 minutes) than patients that waited for ED analgesia. <br/><br/>Conclusion: Despite substantial educational and policy efforts focused on EMS providers, few patients received EMS analgesia, suggesting that low rates of analgesia may be due to patient as well as provider factors. <br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:28:47Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:28:47Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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