where appropriate. Shapiro-Wilks tests for normality were used. Wilcoxon and Kruskal-Wallis tests were used for non-parametric continuous variables. Percentages and frequencies are reported. P < .05 was significant.Results: Five hundred thirty-two patients were included-average age 27 years, 99% male, 40% US or coalition forces. Most procedures were performed by medics. We found no association between ISS score and administration of analgesic agents. 71% of patients received analgesic agents (541 total administrations): ketamine 36%, fentanyl 30%, morphine 25%, hydromorphone 4%, acetaminophen 2%, ketorolac 2%, oxycodone <1%, and ibuprofen <1%. Those who received analgesics were more likely to have had a penetrating injury (89% vs 79%, P ¼ .0057) and less likely to have a blast injury (87% vs 80%, P ¼ .0394) or burn injury (84% vs 58%, P ¼ .0372). Fentanyl was more likely to be administered for ISS >15 (P ¼ .016). Ketamine was less likely to be given for suspected brain injury (P ¼ .001). Injuries involving the chest and/or abdomen were more likely to receive an analgesic agent (P ¼ .04). However, there was no association between the analgesic agent given and anatomical location of injuries. Our outcomes through 30 days post-injury were death 4%, receiving on-going treatment 75%, discharged home 17%, and unknown 4%. Those who received analgesics were more likely to be in continued medical care at 30 days post injury (87% vs 72%, P ¼ .03).Conclusions: In our out-of-hospital study in the combat theater, we found no association between injury severity score and administration of analgesia. When injuries were more severe fentanyl was more likely to be given. In addition, those who received analgesics were more likely to have sustained a penetrating injury and require on-going care at 30 days. Ketamine was less likely to be used in patients with brain injury.
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