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2 Does current pre-hospital analgesia effectively reduce pain in children caused by trauma within a UK ambulance service: a service evaluation
  1. G Whitley,
  2. F Bath-Hextall
  1. University of Nottingham

Abstract

Aim Analgesic treatment of pre-hospital injured children is viewed as ‘suboptimal’ with few receiving analgesia. The aim of this study was to explore current analgesia given to traumatically injured children in the pre-hospital setting and examine whether a clinically meaningful reduction in pain was achieved.

Methods We evaluated electronic patient report forms over a two year period (2013 and 2014) within a UK ambulance service NHS trust. All traumatically injured children within the age range of 1 to 17 with a clinical impression of a fracture, dislocation, wound or burn were included. Patients with a Glasgow Coma Scale of <15 were excluded. The outcome measure was a reduction in numeric pain rating scale or Wong and Baker faces of ≥2 out of 10.

Results Of the evaluable patients (n=11,317), 90.8% had a documented pain score, or a reason why a pain score could not be documented. For patients reporting pain (n=7,483), 51.6% (n=3,861) received analgesia, 9.6% (n=717) received no analgesia but did receive alternative treatment and 38.8% (n=2,905) received no analgesia and no alternative treatment. Morphine sulphate IV, oral morphine, Entonox, paracetamol suspension and poly-analgesia all achieved a clinically meaningful median reduction in pain score.

Conclusion Analgesia administered to traumatically injured children in the pre-hospital setting within this UK ambulance service NHS trust does produce clinically meaningful reductions in pain. The concern is that a large number of patients received no analgesia or alternative treatment. There is a real need to identify barriers to analgesia administration in this patient group.

Conflict of interest None declared.

Funding None declared.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ .

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