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An Assessment of Pain Management Among Patients Presenting to Emergency Medical Services After Suffering a Fall

Published online by Cambridge University Press:  19 June 2014

Allison E. Infinger  and
Jonathan R. Studnek
Allison E. Infinger
Affiliation:
Mecklenburg EMS Agency, Charlotte, North CarolinaUSA
Jonathan R. Studnek*
Affiliation:
Mecklenburg EMS Agency, Charlotte, North CarolinaUSA
*
Correspondence: Jonathan R. Studnek Mecklenburg EMS Agency 4525 Statesville Rd Charlotte, NC 28269 USA E-mail [email protected]
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Abstract

Introduction

Emergency Medical Services (EMS) professionals frequently care for patients experiencing acute pain. Analgesics are critical in patient comfort and satisfaction levels during the treatment of acute pain. The objective of this study was to assess the frequency of pain management in patients suffering a fall, the documented pain score, and the location of their injuries. It was hypothesized that the frequency of analgesia administration was low and would be associated with injury location.

Methods

This was a retrospective review of patients presenting with a complaint of an injury from a fall transported by a single municipal EMS system. Administration of analgesia was the primary outcome variable, with pain severity, injury location, age, gender, race, and distance of fall the independent variables of interest. Pain severity was assessed using a 0-10 scale. Injury location was defined as head/neck, extremities, back, and hip. Patients were deemed ineligible for analgesia, according to local protocol, if they reported chest or abdominal pain, or were hemodynamically unstable as determined by an assessment of pulse and blood pressure.

Results

There were 1,200 patients who were classified as having injuries suffered from a fall, with 76 (6.3%) ineligible for analgesia. Ninety-two (8.2%) patients received analgesia, and they had a mean recorded pain score of 9.1 (95% CI, 8.7-9.5), which was higher than those who did not receive analgesia (5.8; 95% CI, 5.5-6.2). Analgesia administration was associated with injury location; patients experiencing an extremity injury (OR = 13.23; 95% CI, 5.58-31.36; P < .001) or hip injury (OR = 11.65; 95% CI, 4.64-29.24; P < .001) had increased odds of analgesia administration compared to those with head/neck injury. The odds of analgesia administration were decreased for black patients (OR = 0.19; 95% CI, 0.08-0.44; P < .001) when compared to white patients.

Conclusion

Analgesia administration was provided to 10% of eligible patients, and was associated with injury location. Of concern was the number of patients who suffered a fall and did not receive a documented pain score. The results from this study indicated a need for education relating to pain management in patients suffering a fall.

InfingerAE, StudnekJR. An Assessment of Pain Management Among Patients Presenting to Emergency Medical Services After Suffering a Fall. Prehosp Disaster Med. 2014;29(4):1-6.

Keywords

accidental fallEmergency Medical Servicespain management
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 29 , Issue 4 , August 2014 , pp. 344 - 349
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2014 

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References

1. Alonso-Serra, H, Wesley, K. Prehospital Pain Management. Prehosp Emerg Care. 2003;7(4):482-488.Google Scholar
2. McLean, S, Maio, R, Domeier, R. The epidemiology of pain in the prehospital setting. Prehosp Emerg Care. 2002;6(4):402-405.Google Scholar
3. White, L, Cooper, J, Chambers, R, Gradisek, R. Prehospital use of analgesia for suspected extremity fractures. Prehosp Emerg Care. 1999;4(3):205-208.Google Scholar
4. Hennes, H, Kim, M, Pirrallo, R. Prehospital pain management: a comparison of providers’ perceptions and practices. Prehosp Emerg Care. 2004;9(1):32-39.Google Scholar
5. McEachin, C, McDermott, J, Swor, R. Few emergency medical services patients with lower-extremity fractures receive prehospital analgesia. Prehosp Emerg Care. 2002;6(4):406-410.CrossRefGoogle ScholarPubMed
6. American Pain Society Quality of Care Committee. Quality improvement guidelines for the treatment of acute pain and cancer pain. JAMA. 1995;274(23):1874-1880.Google Scholar
7. Michael, GE, Sporer, KA, Youngblood, GM. Women are less likely than men to receive prehospital analgesia for isolated extremity injuries. Am J Emerg Med. 2007;25(8):901-906.Google Scholar
8. Pletcher, MJ, Kertesz, SG, Kohn, MA, Gonzales, R. Trends in opiod prescribing by race/ethnicity for patients seeking care in US emergency departments. JAMA. 2008;299(1):70-78.CrossRefGoogle Scholar
9. Tamayo-Sarver, JH, Hinze, SW, Cydulka, RK, Baker, DW. Racial and ethnic disparities in emergency department analgesic prescription. Am J Public Health. 2003;93(12):2067-2073.Google Scholar
10. Fuentes, EF, Kohn, MA, Neighbor, ML. Lack of association between patient ethnicity or race and fracture analgesia. Acad Emerg Med. 2002;9(9):910-915.Google Scholar
11. Young, MF, Hern, HG, Alter, HJ, Barger, J, Vahidnia, F. Racial differences in receiving morphine among prehospital patients with blunt trauma. J Emerg Med. 2013;45(1):46-52.Google Scholar
12. Abbuhl, FB, Reed, DB. Time to analgesia for patients with painful extremity injuries transported to the emergency department by ambulance. Prehosp Emerg Care. 2003;7(4):445-447.CrossRefGoogle Scholar
13. Jones, KR, Vojir, CP, Hutt, E, Fink, R. Determining mild, moderate, and severe pain equivalency across pain-intensity tools in nursing home residents. J Rehabil Res Dev. 2007;44(2):305-314.Google Scholar
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