Evaluation of the intensity and management of pain before arrival in hospital among patients with suspected hip fractures

Wennberg, Pär; Möller, Margareta; Sarenmalm, Elisabeth Kenne; Herlitz, Johan

doi:10.1016/j.ienj.2019.100825

Cited by 16 publications

(9 citation statements)

References 49 publications

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“…It is possible that some instrumented techniques were used to alleviate the pain instead of drugs, for example Kramer's splint in limb fractures, triangular bandage, placing the patient in a comfortable position or cold pads in case of burns. The similar phenomenon was observed in Sweden where 80% of patients declared a reduction of pain severity without getting any pain medications or obtaining any injury protection procedures [ 25 ]. One of the reasons might be that a large group of patients pays attention mostly to psychological care of medical staff.…”

Section: Discussionsupporting

confidence: 68%

Polish Experiences of Pain Treatment by Paramedics in relation to Good Practices of Pain Treatment: A Register-Based Study

Koral

Szyller

2022

Emergency Medicine International

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Background. Pain is frequently encountered in the prehospital setting. The treatment of pain is one of the priority activities for paramedics. Methods. 1048576 patients under the care of EMS over a 7-month period were included in this study. Data included using pain scale and pain score, the initial diagnosis, analgesic treatment and the given drug obtained from the Ambulance Emergency Procedure Cards. Results. The complete absence of pain was detected in 43.9% (95% CI 43.8–44.0) of patients, mild pain in 17.0% (95% CI 16.9–17.1), moderate pain in 11.6% (95% CI 11.5–11.7), and severe pain in 4.9% (95% CI 4.9–4.9) of cases. In 22.5% (95% CI 22.4–22.6), no pain rating scale was used. 98.0% (95% CI 97.9–98.1) of patients with mild, 96.1% (95% CI 96.0–96.2) with moderate, and 94.0% (95% CI 93.9–94.1) with severe pain did not receive any pain medication. The most commonly used drugs in all groups were metamizole and ketoprofen. The greatest analgesic effect was observed in the group of patients with severe pain. Pain decreased by an average of 3.2 NRS points in the drug-free group and 3.1 NRS points in the treated group. The most commonly documented diagnoses in all groups of patients were signs and diseases not classified in other groups (ICD-10 R00-R99), injuries and consequences of external causes (ICD-10 S00-T98), and diseases of the circulatory system (ICD-10 I00–I99). Conclusions. Paramedics may use a variety of medications but use them rarely. Adding metamizole to the list of medications used by paramedics has made it one of the most commonly used drugs. Regardless of whether the drug was used or not, the analgesic effect was similar.

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Section: Discussionsupporting

confidence: 68%

Polish Experiences of Pain Treatment by Paramedics in relation to Good Practices of Pain Treatment: A Register-Based Study

Koral

Szyller

2022

Emergency Medicine International

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“…Participants with CLBP were recruited via poster and social media announcements. The inclusion criteria were: (1) having intermittent low back pain for at least 12 weeks, (2) participant age range 20 to 60 years, and (3) a pain numeric rating scale (NRS) score between 4 and 7 [27][28][29]. Participants were excluded if they had: (1) a contraindication to radiographic assessment, such as pregnancy, (2) acute fracture, tumor, or infection, (3) a history of serious neurological or psychiatric disease, (4) previous lumbar fusion surgery, or (5) a diagnosis of radiological lumbar instability (LI), spondylolisthesis, or lumbar disc herniation [1,5,30].…”

Section: Participantsmentioning

confidence: 99%

Validity of a Screening Tool for Patients with a Sub-Threshold Level of Lumbar Instability: A Cross-Sectional Study

Leungbootnak

Puntumetakul

Kanpittaya

et al. 2021

IJERPH

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Lumbar instability (LI) comprises one subgroup of those with chronic low back pain (CLBP); it indicates the impairment of at least one of the spinal stabilizing systems, and radiographic criteria of translation and rotation are used for its diagnosis. Previous studies have developed and tested a screening tool for LI where patients with sub-threshold lumbar instability (STLI) were detected in the initial stage of lumbar pathology using radiographs as a gold standard for diagnosis. The radiographic measurement in STLI lies between the range of translation and rotation of the LI and asymptomatic lumbar motion. However, there are no studies indicating the validity and cut-off points of the screening tool for STLI. The current study aimed to determine the validity of an LI screening tool to support the diagnostic process in patients with STLI. This study design was cross-sectional in nature. A total of 135 participants with CLBP, aged between 20 and 60 years, who had undergone flexion and extension radiographs, answered a screening tool with 14 questions. The cut-off score for identifying STLI using the screening tool was at least 6/14 positive responses to the LI questions. The findings suggested that the LI screening tool we tested is effective for the detection of STLI. The tool can be used in outpatient settings.

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“…Essa atividade acrescenta ao enfermeiro maior responsabilidade na assistência prestada, pois ele deve entender de medicações e suas interações medicamentosas com mais rigorosidade. Ainda, o enfermeiro no contexto de APH tem como responsabilidade aplicar a Escala Numérica de Avaliação (NRS) para ponderar o grau de sofrimento de dor do paciente, transferindo humanização no atendimento (Wennberg et al, 2020).…”

Section: Resultsunclassified

Nurses' role in urgent and emergency mobile pre-hospital care

Santos¹,

Santos²,

Costa³

et al. 2022

JRKS

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In the mobile pre-hospital environment such as the SAMU, the nurse has several functions in the areas of care, administration, operation and supervision, and must participate in the review of protocols and provide training for the other professionals in the team. Despite this, changes have been taking place over the years in relation to the performance of nursing, improving legal aspects and increasing the autonomy of nurses. The general objective of the research is to analyze the role of nurses in urgent and emergency mobile pre-hospital care, and as specific objectives to describe the nurse's attributions as a member of the urgent and emergency mobile PHC service team, to point out the difficulties and challenges exist in the nurse's work and discuss the importance of the nurse in the mobile emergency APH. Thus, the present work is an integrative literature review, using the following descriptors: “emergency assistance”, “pre-hospital care” and “emergency nursing”. The work was prepared between February and May 2022, using studies published between 2012 and 2022. Such works were found in the SCIELO, LILACS and MEDLINE databases. As a result, the nurse must act as an advisor by participating in the review of protocols, in the elaboration and organization of educational content and as a professional of the multidisciplinary team of accidents and disasters. However, the nurse in the PHC has been exposed to unfavorable ergonomics, low salaries, exhausting workload, influencing their physical and mental health. Thus, the role of nurses in the PHC is still fragmented, developing little autonomy, despite being extremely important in the composition of the team, as it promotes assistance, management, education, leadership and humanization. Still, the need for continuing education with realistic theoretical-practical training for SAMU nurses was proved, with an emphasis on mental health for patients in psychiatric crisis.

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Evaluation of the intensity and management of pain before arrival in hospital among patients with suspected hip fractures

Cited by 16 publications

References 49 publications

Polish Experiences of Pain Treatment by Paramedics in relation to Good Practices of Pain Treatment: A Register-Based Study

Polish Experiences of Pain Treatment by Paramedics in relation to Good Practices of Pain Treatment: A Register-Based Study

Validity of a Screening Tool for Patients with a Sub-Threshold Level of Lumbar Instability: A Cross-Sectional Study

Nurses' role in urgent and emergency mobile pre-hospital care

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