1. Williams, Brett. and Myers, Jeff. "Medications Utilized for Prehospital Analgesia" Paper presented at the annual meeting of the National Association of EMS Physicians, Registry Resort, Naples, FL, <Not Available>. 2009-12-06 <http://www.allacademic.com/meta/p64863_index.html>Publication Type: Abstract
Abstract: Introduction:
Pain is the number one complaint of emergency department patients, however pain management continues to be poorly studied and published in the prehospital setting. Recent literature shows that approximately 1.8-18.3% of patients with extremity fractures receive any type of analgesia prior to ED arrival. In this study, we sought to determine the specific medications available to EMS providers for adult and pediatric analgesia.
Methods:
The subject population was solicited by e-mail sent to five Internet list groups that included members who provide prehospital emergency care. Subjects completed an anonymous 21-question web based survey that was available for a two-week period with a reminder e-mail sent at day 10. Survey results were tabulated directly from the website submission page to a Microsoft Access database and analyzed in Microsoft Excel. This study was approved by the University’s behavioral science research IRB.
Results:
A total of 158 persons responded to the survey. Four responses were discarded as they were duplicated responses, leaving a total of 154 for analysis, 146 from the US and 8 International. For adult analgesia, international respondents cited morphine as the most common analgesic (88%), followed by fentanyl (63%) and then ketorolac (25%). For US respondents, morphine was the most common analgesic (97%), followed by fentanyl (40%), and then demerol (23%). For pediatric analgesia, morphine (88%) and fentanyl (50%) were the most common analgesics. For US respondents, morphine (90%), fentanyl (35%), and acetaminophen (16%) were the most common analgesics available to EMS providers. For adult indications, other medications included tramadol (1%), nalbuphine (13%), ibuprofen (12%), hydromorphone (6%), and acetaminophen (19%). For pediatric indications, other medications nalbuphine (8%), ketorolac (11%), ibuprofen (8%), hydromorphone (2%), demerol (13%). Additional medications cited by respondents included methoxyflourane, nitrous oxide/oxygen, diamorphine, and metamizol.
Conclusions:
Morphine and fentanyl are the most commonly used prehospital analgesics. Several additional medications are available on a less frequent basis. |
