Global Comparative Survey - PHEM Analgesia

DrWeaver3

DrWeaver3

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Hello All!

My name is Klara Weaver, I’m a doctor in the NHS in the UK. I am running a global comparative survey of pre-hospital analgesics carried by EMTs, paramedics and pre-hospital doctors. It aims to look at what EMS services carry in their ambulances, analgesia protocols and protocol adherence. All responses are anonymous and the data will be used to look at global attitudes towards pain relief in the pre-hospital setting.

As it is a survey there is no study protocol or need for ethical approval as no patient data is being handled.

I’m looking to represent the under-reported services in the world so that every country has a chance to participate in the discussion about pre-hospital pain relief. I would greatly appreciate it if you could forward this link to EMTs, Paramedics and Doctors working in the prehospital environment within your country.

Please don’t hesitate to ask me if you have any further questions.

I'd like to include a link but this is my first post....

PM me or email me on klaraweaver@doctors.org.uk if you think you can help/want to pass the survey on. Particularly looking for Paramedics/EMTs in Mexico and South America as I have no data for those areas yet.
 
Jim37F

Jim37F

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My experience from Los Angeles County, CA.....EMTs (BLS) had basically no meds (only Oxygen and Oral Glucose), pain relief is limited to cold packs and positioning. Paramedics seemed to only ever give Morphine for pain, I never once saw any other med given for pain (somehow I doubt you're including Nitroglycerin and ASA administered for chest pain calls as that's not their purpose), that and the ALS departments we ran with (BLS ambulance service running transport for ALS fire departments with medics in Squads) were really super stingy on giving any pain meds, I don't have any hard numbers, but the vast majority of the trauma patients (even those with obvious signs of trauma and in pain) never got anything beyond BLS measures.....I think once in the 5 years I was in EMT in LA Co I saw medics give pain meds for non-traumatic pain (abdominal pain).....one of many reasons I'm happy to NOT be in LA anymore.....
 
EpiEMS

EpiEMS

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Most BLS providers in the U.S. don't have anything in the way of pain control beyond splinting, ice packs, and words of comfort. As the National Scope of Practice Model makes pretty clear, pharmacological pain control is considered to be beyond the scope of BLS providers - this model is *not* authoritative for all areas, but gives a good sense for where we are as nation as far as EMS is concerned. In the U.S., EMS is governed differently by every municipality and/or state.

Some U.S. BLS providers do have NSAIDs for pain management. For example, in Maryland, EMTs can administer acetaminophen (paracetemol) PO up to 625mg for adults. And in Montana, there are waivers for EMTs to administer morphine IM.

SpecialK said:
G'day mate ....

In New Zealand we have: paracetamol, ibuprofen, tramadol, morphine, fentanyl, ketamine, methoxyflurane, ring blocks and something else I can't remember ... and just withdrew entonox on June of this year; smh, seriously ... loved entonox.

Rather than repeating everything; just read the "analgesia" section of the comprehensive CPGs located here: https://www.stjohn.org.nz/globalass...practitioners/cpg_comprehensive_web170525.pdf
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Color me jealous!
 
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DrWeaver3

DrWeaver3

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SpecialK said:
G'day mate ....

In New Zealand we have: paracetamol, ibuprofen, tramadol, morphine, fentanyl, ketamine, methoxyflurane, ring blocks and something else I can't remember ... and just withdrew entonox on June of this year; smh, seriously ... loved entonox.

Rather than repeating everything; just read the "analgesia" section of the comprehensive CPGs located here:


Thanks so much for your reply! NZ have such nice guidelines, very clear cut. May I ask why you're phasing out entonox? We love it here in the UK too.
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SpecialK

SpecialK

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DrWeaver3 said:
May I ask why you're phasing out entonox? We love it here in the UK too.
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There's no good answer, I think partly due to cost (expensive to rent and refill approximately 600 cylinders) plus to remove complexity for staff in decision making around entonox v MOF. Australia has only used MOF for ages now.
 
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