Analgesia in trauma patients administered by Emergency Medical Services

• Main Authors: Łukasz Zduńczyk, Piotr Konrad Leszczyński, Oryna Detsyk, Anna Charuta
• Format: Article
• Language: English
• Published: Towarzystwo Pomocy Doraźnej 2019-03-01
• Series: Critical Care Innovations
• Subjects: emergency medical service; analgesia; trauma; pain
• Online Access: https://www.irdim.net/cci/2(1)11-21.html

INTRODUCTION: A pain response is an inevitable symptom in trauma patients and requires to undertake a medical intervention in pre-hospital conditions. In the Polish system of medical rescue, there are teams including a doctor or without one where a paramedic is the main person to make decisions. Due to lack of standard procedures and a pain rating scale attached to the documents of medical rescue teams, the authors of the research attempted to analyse the administration of analgesics in trauma patients. MATERIAL AND METHODS: The research was conducted on 266 trauma patients selected from 2307 interventions of Emergency Medical Service in Łęczyca in 2016. ANOVA, one-way analysis of variance, and T-tests for unpaired samples were applied. All the results were found significant at p < 0,05. RESULTS: The study was carried out on 150 males and 100 females. The average age of the the trauma patients was 77 (SD ± 38). Rescue teams were sent to trauma patients at 71-80 and 51-60 age groups. In 64,7 % (n=172) of the cases, help was provided in rural areas, whereas in 35,3 % (n=94) cases - urban areas. Most frequently, the patients were injured as a result of traffic accidents, activities while carrying out farm work as well as cut wounds and self-mutilation. Anaesthesia was applied in 120 cases (45,11%), mostly in patients between the age of 81 and 90 and most rarely in children. A total number of painkiller administration was higher in basic Emergency Medical Services (BEMS) than in specialized ones (S-EMS) (84 vs. 55). No statistically significant relation between the choice of the medicine and the injury type was discovered (Kruskal-Wallis; p=0,82). The drug used most often was Ketoprofenum (n=87) and Fentanylum (n=35). There was significant difference in the administration of analgesic drugs between BEMS and S-EMS teams (χ2; p=0,042). CONCLUSIONS: Over half of the trauma patients was not secured by administering analgesic drugs in pre-hospital conditions. The number of analgesic drugs used in B-EMS and S-EMS teams was diverse. Patients were given nonsteroidal anti-inflammatory drugs (NSAIDs) more often than opioids.