Prevalence and Relief of Pain in Trauma Patients in Emergency Medical Services

Abstract

Prevalence of pain in trauma was high, and without consistent "objective" reporting of pain it is difficult to evaluate the effectiveness of pain management, despite the adherence to clinical practice guideline or protocol. Paramedics need to elicit and report validated pain measurements.

Exploring Opioid-Sparing Multimodal Analgesia Options in Trauma: A Nursing Perspective

“…Ice packs are used to reduce swelling/edema and associated pain in a variety of trauma injuries (Berben et al, 2011; Rana et al, 2013). Circulating cold water therapy reduced postoperative fracture pain more than conventional cooling (Rana et al, 2013), and a cold pressure system reduced opioid consumption versus epidural after knee arthroplasty (Holmström & Härdin, 2005).…”

“…In 2011, injuries were responsible for more than 40 million visits to emergency departments (EDs) in the United States (National Center for Health Statistics & Ambulatory and Hospital Care Statistics Branch, n.d.). Pain is reported in at least 70% of trauma-related injuries (Berben, Schoonhoven, Meijs, van Vugt, & van Grunsven, 2011), and undertreated acute pain may contribute to delirium, particularly in geriatric patients (McKeown, 2015); prolonged need for mechanical ventilation; and delayed mobilization (Barr et al, 2013). Acute pain is cited as a predictor of chronic pain development (McGreevy, Bottros, & Raja, 2011; Trevino, Harl, Deroon-Cassini, Brasel, & Litwack, 2014).…”

Acute Postoperative Pain in Trauma Patients - The Fifth Vital Sign

“…The median of pain intensity measured right on patients admission to the hospital was 7 (interquartile range 4-10), and our results are similar to those revealed in Berben et al (2011). Their respondents averagely rated pain intensity with pain score 6 (interquartile range 3-8), while the polytrauma patients reported a high median pain score 8 (interquartile range 7-10) [11]. Despite the pain treatment and the use of different analgesics, patients are still reporting that they feel postoperative pain.…”

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

“…Similar to Gerhardt et al's finding 28 that 44% of records had severe or maximum pain scores, 42% of patients in this sample reported severe pain (7-10), but there was not sufficient documentation of pain reassessment to determine if pain treatment was adequate for these patients. Patients with very similar injuries reported widely differing pain scores, as found in previous studies of both military and civilian trauma patients 3,4,75,96,97. While we analyzed all available data, our model accounted for only 5% of the variance.…”

“…[3][4][5] Inadequately treated pain can interfere with recovery from trauma and become chronic and debilitating, 6,7 and increase risk for posttraumatic stress disorder (PTSD). [8][9][10] For example, 46−80% of civilian trauma survivors report persistent post-trauma pain measured 4 months to 6 years postinjury.…”