Compliance with a Morphine Protocol and Effect on Pain Relief in Out-of-Hospital Patients

Ricard-Hibon, A.; Belpomme, Vanessa; Chollet, C.; Devaud, Marie-Laure; Adnet, Frédéric; Borron, Stephen W.; Mantz, Jean; Marty, J.

doi:10.1016/j.jemermed.2007.06.003

Cited by 29 publications

(12 citation statements)

References 41 publications

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“…Failure to provide adequate analgesia is associated with a number of undesirable outcomes, one of which is the potential development of hyperalgesia, an adapted central nervous system condition in which patients experience an abnormally heightened response to future pain stimuli ( 15 – 17 ). Untreated acute pain has also been known to lead to irreversible chronic or neuropathic pain as well as depression, post-traumatic stress disorder and poor compliance with rehabilitation strategies ( 16 – 19 ).…”

Section: Management Of Pain In the Prehospital Contextmentioning

confidence: 99%

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Use of Morphine Sulphate by South African Paramedics for Prehospital Pain Management

Vincent-Lambert

Kock²

2015

Pain Research and Management

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Pain management in the prehospital setting (ie, in patients being transported to the emergency department) has been described as inadequate in the literature, similar to pain management in the emergency department. Morphine is one of the most commonly used analgesics administered by paramedics who are treating patients being transported to hospital. This study included 60 paramedics practicing in South Africa, who responded to a survey querying their use of morphine in the prehospital environment. The results reveal the ways in which actual morphine administration differs from recommendations on administration, and suggests reasons for this as well as potential resolutions.

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Section: Management Of Pain In the Prehospital Contextmentioning

confidence: 99%

“…The safety and advantages of morphine sulphate administration have been well documented ( 2 – 15 , 21 ), resulting in morphine becoming the most commonly used agent for analgesia in the South African prehospital environment.…”

Section: Management Of Pain In the Prehospital Contextmentioning

confidence: 99%

Use of Morphine Sulphate by South African Paramedics for Prehospital Pain Management

Vincent-Lambert

Kock²

2015

Pain Research and Management

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“…19 Other studies examining paramedic compliance with prehospital analgesia protocols demonstrate that it is feasible for paramedics to administer analgesia within 10-20 minutes of the beginning of the clinical encounter. 20,21 In formulating their recommendation, the panel placed high importance on expeditious pain relief, and a lower priority on the resources required to provide effective prehospital analgesia, i.e., need for IV access, availability of medication, and prior training. Since it has been demonstrated that time to administration of pain relief for patients with fractures is significantly reduced if analgesia is initiated in the prehospital setting, the committee felt strongly that initiation of prehospital pain management improves outcomes for patients with painful conditions.…”

Section: Should the Length Of Transport Interval Influence The Assessmentioning

confidence: 99%

An Evidence-based Guideline for Prehospital Analgesia in Trauma

Gausche‐Hill¹,

Brown²,

Oliver³

et al. 2013

Prehospital Emergency Care

120

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Background. The management of acute traumatic pain is a crucial component of prehospital care and yet the assessment and administration of analgesia is highly variable, frequently suboptimal, and often determined by consensus-based regional protocols. Objective. To develop an evidence-based guideline (EBG) for the clinical management of acute traumatic pain in adults and children by advanced life support (ALS) providers in the prehospital setting. Methods. We recruited a multi-stakeholder panel with expertise in acute pain management, guideline development, health informatics, and emergency medical services (EMS) outcomes research. Representatives of the National Highway Traffic Safety Administration (sponsoring agency) and a major children's research center (investigative team) also contributed to the process. The panel used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to guide the process of question formulation, evidence retrieval, appraisal/synthesis, and formulation of recommendations. The process also adhered to the National Prehospital Evidence-Based Guideline (EBG) model process approved by the Federal Interagency Council for EMS and the National EMS Advisory Council. Results. Four strong

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“…Unfortunately, we were unable to detect a change in postmorphine pain scores, which would be an ideal patient-centered outcome measure. While others have shown that a change in a local prehospital protocol for pain management can result in improved outcomes, including pain relief and time to pain medication, 5,6 we are not aware of any other published report that specifically addresses the implementation of an evidence-based guideline in a state-wide EMS system.…”

Section: Discussionmentioning

confidence: 95%

The Implementation and Evaluation of an Evidence-based Statewide Prehospital Pain Management Protocol Developed using the National Prehospital Evidence-based Guideline Model Process for Emergency Medical Services

Brown

Hirshon

Alcorta

et al. 2013

Prehospital Emergency Care

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Background. In 2008, the National Highway Traffic Safety Administration funded the development of a model process for the development and implementation of evidence-based guidelines (EBGs) for emergency medical services (EMS). We report on the implementation and evaluation of an evidencebased prehospital pain management protocol developed using this model process. Methods. An evidence-based protocol for prehospital management of pain resulting from injuries and burns was reviewed by the Protocol Review

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Compliance with a Morphine Protocol and Effect on Pain Relief in Out-of-Hospital Patients

Cited by 29 publications

References 41 publications

Use of Morphine Sulphate by South African Paramedics for Prehospital Pain Management

Use of Morphine Sulphate by South African Paramedics for Prehospital Pain Management

An Evidence-based Guideline for Prehospital Analgesia in Trauma

The Implementation and Evaluation of an Evidence-based Statewide Prehospital Pain Management Protocol Developed using the National Prehospital Evidence-based Guideline Model Process for Emergency Medical Services

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