Prehospital pain management in an urban emergency department

The aim of this study is to investigate various forms of pain management in prehospital emergency care and to get more information about the administration of analgesics in prehospital patients. Data concerning the analgesic therapy were drawn from 5810 patients' charts of an urban emergency department during the years 1993 - 1995. 581 (10%) of these cases were considered to have a clearly defined painful disease or injury. We tried to show a relationship between the dose and form of administration of the analgesics used for treatment of these patients and their prehospital diagnosis. Results: Only 54% of the patients included in the study received analgesics. Opioids (73%) were more often administered than nonopioid analgesic drugs. Analgesics were most frequently used for patients with cardiopulmonary diseases (68.1%), followed by patients with traumatic accidents (44.5%) and patients with acute abdominal pain (40.5%). There is little difference between the pain management practised by anaesthetists and surgeons. The results of our investigation demonstrate that very often the pain therapy is not individualized to the patient's needs. New concepts concerning pain management could contribute to improvement of pain therapy in prehospital emergency medicine.