Pre-hospital pain management: the paramedics’ perspective

Abstract

Current research studies regarding pre-hospital pain management focus on the range and efficacy of analgesics available. However, the attitudes and perceptions of paramedics towards patients in pain have not been explored. The aim of this study therefore, was to explore paramedics' perceptions of patients in pain and the paramedics' perspective of pre-hospital pain management. This qualitative exploratory study utilised semi-structured interviews to collect in-depth data from six paramedics working in a UK urban ambulance service. The interviews were audio tape-recorded, transcribed and then analysed using a thematic content analysis framework. The participants described factors which they felt influenced a patient's experience of pain, identifying a cultural difference to exist in pain expression. Patients were not always perceived by the participants to be honest when describing their pain and this was one of several reasons influencing the decision not to administer analgesia. This study has revealed small deficits in knowledge, highlighted where additional training would be of benefit and established areas to explore through further research.

TENS Relieves Acute Posttraumatic Hip Pain During Emergency Transport

“…This situation is uncomfortable for both the patient and the involved medical personnel. 24 Apart from this important emotional component, pain also provokes autonomic responses that markedly increase adrenergic neural activity and plasma catecholamine levels. Increased heart rate, hypertension, and arterial vasoconstriction are the result, and these can adversely affect old and multimorbid patients during their transport to the hospital.…”

Prevalence and Predictors of Prehospital Pain Assessment and Analgesic Use in Military Trauma Patients, 2010–2013

“…Our finding that PH documentation of pain scores was missing more frequently than PH physiologic assessment parameters may indicate that clinicians do not view the parameters as equally valuable, 92,93 or that organizational support to ensure complete documentation is lacking. Further research is needed to better understand the reasons for the observed differences and guide effective interventions to systematically improve processes of pain assessment and treatment.…”

An Ethnography of the Culture of Pain in a Non-Pediatric Emergency Department

“…The empirical literature demonstrates that healthcare provider attitudes and preconceived notions about the patient's age, behaviors, diagnoses and personalities may influence pain management practices (Brockopp, Ryan, & Warden, 2003;Broome & Huth, 2003;Hennes et al, 2005;Jones & Machen, 2003;Kim et al, 2003;Melhuish & Payne, 2006;Miner, Biros, Trainor, Hubbard, & Beltram, 2006;Rasmussen, Frederiksen, Hallonsten, & Poulsen, 2005;Twycross, 2002;Twycross, 2007b;Twycross, 2008;Vincent, 2005;Woodgate & Kristjanson, 1996a). Studies have demonstrated that numerous assumptions and personal beliefs by healthcare professionals may interfere with the optimal recognition and treatment of pain.…”

“…Various qualitative studies reported similar perceptions of pain management in healthcare providers. Interviews with paramedics reported the belief that some cultures magnify their pain as the patients' feel they are ignored due to language barriers and related issues (Jones & Machen, 2003).…”

“…The aforementioned findings were limited to nurses' experience on medical, and surgical pediatric units (Melhuish & Payne, 2006;Salanterȁ, 1999;Twycross, 2002Twycross, , 2007bTwycross, , 2008Vincent, 2005;Woodgate & Kristjanson, 1996a), dentists' (Rasmussen et al, 2005), and paramedics in the pre-hospital setting (Hennes et al, 2005;Jones & Machen, 2003). Of those studies related to emergency practice, findings were based on physicians' perceptions of adult patients in pain (Juhl & Conners, 2005;Miner et al, 2006), and the opinion and practice of pediatric emergency medicine physicians and pediatric surgeons in children with acute abdominal pain (Kim et al, 2003).…”