Mohammad Iqbal, research fellow and PhD student at the University of Lincoln and research associate at East Midlands Ambulance Service (EMAS), together with Anne Spaight (senior research fellow at the University of Lincoln and Head of Clinical Governance, Audit and Research at EMAS) and Niro Siriwardena (professor of primary and prehospital health care) have a new study published online in the Emergency Medical Journal. The study entitled: ‘Patients’ and emergency clinicians’ perceptions of improving pre-hospital pain management: a qualitative study’ follows on from an earlier study investigating prehospital pain management which showed that under two-fifths of patients with a painful condition (heart attack or fracture) were provided with pain relief.
Although patients and staff expected pain to be relieved in the ambulance, refusal of or inadequate analgesia were common. Pain was often assessed using a verbal pain score, but practitioners’ views of severity were sometimes different from patients’ views. Morphine and Entonox were commonly used to treat pain, but reassurance, positioning and immobilisation were used as alternatives to drugs.
The authors concluded that pre-hospital pain management could be improved by addressing practitioner and patient barriers, increasing available drugs and developing multi-organisational pain management protocols supported by training for staff. These findings may be used to inform guidance, education and policy to improve the pre-hospital pain management pathway.
Niro Siriwardena co-leads the NIHR Programme Grant for Applied Research: Prehospital Outcomes for Evidence based Evaluation (PhOEBE).