Physician staffed ambulances are better for patient's analgesia on arrival at the emergency department

被引:7
作者
Bounes, V. [1 ]
Concina, F. [1 ]
Lecoules, N. [1 ]
Olivier, M. [1 ]
Lauque, D. [1 ]
Ducasse, J. -L. [1 ]
机构
[1] Hop Univ Toulouse, F-31059 Toulouse 9, France
来源
ANNALES FRANCAISES D ANESTHESIE ET DE REANIMATION | 2010年 / 29卷 / 10期
关键词
Acute pain; Analgesia; Emergency department; Prehospital setting; Trauma; Anxiety; Analgesic fracture splinting; ACUTE PAIN; INTENSITY; ANXIETY;
D O I
10.1016/j.annfar.2010.06.018
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Objectives. - To find out prehospital factors linked with low pain on arrival into a traumatic emergency unit. Methods. - A 4-month monocentric prospective study, including patients recruited at their arrival into a traumatic emergency unit. Pain (with a numerical rating scale [NRS]), anxiety, prehospital care including the type of transportation (Physician staffed ambulances Smur, emergency medical technicians or firemen ambulances), immobilization and analgesics used were evaluated. These data were collected on arrival at the hospital by the ED orientation nurse. Uni- and multivariate analysis were performed to identify low pain's predictive factors (e.g. with a NRS <= 3). Results. - Three hundred and four patients were recruited, mean age = 51 +/- 25, sex ratio = 1.8, mean pain/10 = 5.8 +/- 2.9, 64% with a moderate or severe pain on arrival (NRS > 3). For one third of patients, immobilizations hadn't been performed during the prehospital phase. Medical management by Smut is a low pain predictive factor (OR = 5.8; CI 95% = 1.4-24.16), anxiety is a pejorative factor (OR = 0.53 CI 95% = 0.38-0.75). Conclusion. - Our study highlights the physician staffed ambulances' effectiveness in prehospital trauma victim's management and raises the question of anxiolysis as an adjuvant for traumatic pain management. (C) 2010 Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:699 / 703
页数:5
相关论文
共 21 条
  • [1] Abbuhl Frederick B, 2003, Prehosp Emerg Care, V7, P445
  • [2] Factors associated with delay to opiate analgesia in emergency departments
    Arendts, Glenn
    Fry, Margaret
    [J]. JOURNAL OF PAIN, 2006, 7 (09) : 682 - 686
  • [3] Comparative study of methods of measuring acute pain intensity in an ED
    Berthier, F
    Potel, G
    Leconte, P
    Touze, MD
    Baron, D
    [J]. AMERICAN JOURNAL OF EMERGENCY MEDICINE, 1998, 16 (02) : 132 - 136
  • [4] Lack of influence of patient self-report of pain intensity on administration of opioids for suspected long-bone fractures
    Bijur, Polly E.
    Berard, Anick
    Esses, David
    Nestor, Jordan
    Schechter, Clyde
    Gallagher, E. John
    [J]. JOURNAL OF PAIN, 2006, 7 (06) : 438 - 444
  • [5] Blettery B, 1996, REAN URG, V5, P691
  • [6] Is there an ideal morphine dose for prehospital treatment of severe acute pain?: A randomized, double-blind comparison of 2 doses
    Bounes, Vincent
    Charpentier, Sandrine
    Houze-Cerfon, Charles-Henri
    Bellard, Cedric
    Ducasse, Jean Louis
    [J]. AMERICAN JOURNAL OF EMERGENCY MEDICINE, 2008, 26 (02) : 148 - 154
  • [7] THE RISK OF DETERMINING RISK WITH MULTIVARIABLE MODELS
    CONCATO, J
    FEINSTEIN, AR
    HOLFORD, TR
    [J]. ANNALS OF INTERNAL MEDICINE, 1993, 118 (03) : 201 - 210
  • [8] HARRELL J, 1985, CANC TREAT REP, V69, P1071
  • [9] Hennes Halim, 2005, Prehosp Emerg Care, V9, P32, DOI 10.1080/10903120590891705
  • [10] KUDO M, 1995, HIGASHI NIPPON DENT, V14, P7