Where is the paramedic profession going with pain management?

Hodkinson, Mark

doi:10.12968/jpar.2016.8.3.118

Cited by 7 publications

(5 citation statements)

References 11 publications

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“…NSAIDs are the most prescribed analgesic drugs in the world, and their efficacy in the treatment of acute pain has been repeatedly demonstrated [ 4 , 29 , 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…Their action is based on inhibition of the reversible cyclooxygenase enzyme that mediates the production of prostaglandins and thromboxane A2 [ 4 ]. Prostaglandins are involved in various physiological functions, such as the maintenance of gastric mucosal integrity, regulation of kidney blood flow and regulation of endothelial tone; they also play a key role in inflammatory and nociceptive processes.…”

Section: Discussionmentioning

confidence: 99%

“…Regional anesthesia (RA) has all the characteristics of being a first-order analgesic technique [ 4 , 6 ]. Moreover, new innovative techniques, such as ultrasound [ 43 , 44 ], permit its use more safely and limit the risks of blinding procedures [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Pain relief is one of the most prevalent requests among trauma patients in emergency rooms [ 3 ]. These types of patients also frequently complain of not being cared for enough in terms of pain control [ 4 ]. Pain control leads to the decrease of stress response effects, such as tachycardia with subsequent myocardial ischemia or fatal congestive heart failure.…”

Section: Introductionmentioning

confidence: 99%

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Acute Traumatic Pain in the Emergency Department

et al. 2023

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Trauma is a major cause of mortality throughout the world. Traumatic pain—acute, sudden, or chronic—is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage”. Patients’ perceptions of pain assessment and management have become an important criterion and relevant outcome measure for healthcare institutions. Several studies show that 60–70% of ER patients experience pain, and more than half of them express a feeling of sorrow, which can be moderate or severe, at triage. The few studies that have analyzed how pain is assessed and managed in these departments agree that approximately 70% of patients receive no analgesia or receive it with remarkable delay. Specifically, less than half of the patients receive treatment for pain during admission and 60% of discharged patients have higher intensity pain than at admission. Trauma patients are also the ones who most commonly report low satisfaction with pain management. Associated with this lack of satisfaction, we can describe the poor use of tools for measuring and recording pain, poor communication among caregivers, inadequate training in pain assessment and management, and widespread misconceptions among nurses about the reliability of patients’ estimation of pain. The aim of this article is to review the scientific literature to explore the methodologies of pain management in trauma patients attending the emergency room and analyzing their weaknesses as a starting point to improve the approach to this, unfortunately too often, underestimated issue. A literature search was performed using the major databases to identify relevant studies in indexed scientific journals. The literature showed that the multimodal approach in trauma patients is the best approach to pain management. It is becoming increasingly crucial to manage the patient on multiple fronts. Drugs acting on different pathways can be administered together at lower doses, minimizing risks. Every emergency department must have staff trained in the assessment and immediate management of pain symptoms as this allows the reduction of mortality and morbidity and shortens hospital stays, contributing to early mobilization, reduced hospital costs, and enhanced patient satisfaction and quality of life.

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“…NSAIDs are the most prescribed analgesic drugs in the world, and their efficacy in the treatment of acute pain has been repeatedly demonstrated [ 4 , 29 , 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Acute Traumatic Pain in the Emergency Department

et al. 2023

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“…Other factors of consideration include the paramedics scope of practice and legal aspects associated with the use of analgesic and pain medication. Controlled medication may be potentially lethal if inappropriately administered (Hodkinson, 2016). These elements may further influence or impede the decision-making process of paramedics in deciding what pain relief option to adopt.…”

Section: Introductionmentioning

confidence: 99%

Considerations on out-of-hospital pain assessment of a diverse population

Alinier

Dippenaar

Gangaram

2021

International Paramedic Practice

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Nearly all medical emergency calls are related to someone experiencing some form of discomfort—either due to trauma or pain. Initial pain assessment may be undertaken over the telephone by an emergency medical dispatcher, without seeing the patient; however, the next key moment in pain assessment is completed patient-side by the paramedic. This inquiry is detailed and guides the paramedic in the formation of a differential diagnosis and provision of appropriate pain management. The research team recently conducted and published a study on pain assessment which raised concerns on the subjectivity of pain scoring. The work presented was in the context of a very multicultural environment. The aim of this commentary article is to further explore this topic and encourage health professionals to reflect on this aspect of patient assessment.

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A critical review of NICE Guideline 39—major trauma: assessment and initial management

Hodkinson

2016

Journal of Paramedic Practice

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Major trauma is a leading cause of death in the under 40 years age group, and has a significant impact on morbidity, causing a financial burden to the National Health Service ( National Audit Office, 2010 ). A recent guideline published by the National Institute for Health and Care Excellence ( NICE, 2016a ) seeks to address the recommendations made by a National Confidential Enquiry into Patient Outcome and Death (2007) and the National Audit Office (2010) , therefore improving the standards of trauma care delivery across England. This article critically appraises the recommendations made by NICE (2016a) , while considering the available evidence and the implications on pre-hospital major trauma care.

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Where is the paramedic profession going with pain management?

Abstract: Pain management is a contemporary issue in pre-hospital care. Mark Hodkinson outlines how in recent years, the development of specialist paramedic roles and changes in laws relating to the control of drugs has seen advances in the array of analgesic options available to paramedics.

Cited by 7 publications

References 11 publications

Acute Traumatic Pain in the Emergency Department

Acute Traumatic Pain in the Emergency Department

Considerations on out-of-hospital pain assessment of a diverse population

A critical review of NICE Guideline 39—major trauma: assessment and initial management

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