A Guide to Prehospital Pain Management

EMS providers routinely treat patients with pain; it's the most common reason patients seek medical attention in the ED.1 Providers who understand the physiologic mechanism that causes pain, the physiologic response to pain and the methods with which to control it are best equipped to care for these patients. Pain control is as much an art as a science.
Appropriately titrated doses and careful patient monitoring minimize the risk of harmful side effects from pain medications. However, studies show that patients consistently receive inadequate doses or no pain control during their interaction with the medical community.2 This is especially true in the pediatric trauma population as well as non-Caucasians, but many factors contribute to the undertreatment of pain.3,4
Although recent concerns about the national opioid epidemic involving prescribed, non-prescribed and recreational opiates are creating a revision of practice guidelines for opiate medications, it's still widely believed that prehospital providers have a low risk of creating opioid abuse when using medications properly. This is especially true in the setting of obvious injury.
Prehospital providers may harbor concerns that aggressive pain management will delay or prohibit an accurate diagnosis by a receiving physician. To alleviate this concern, consider different causes of pain: A patient with an obvious extremity fracture shouldn't be denied pain medicine for fear of clouding another diagnosis.

The basic techniqu...

Source: JEMS Patient Care - November 1, 2016 Category: Emergency Medicine Authors: Paul E. Phrampus, MD Tags: Patient Care Source Type: news