EFFICACY OF PAIN MANAGEMENT IN PREHOSPITA L EMERGENCY CARE

The aim of this study was to evaluate the quality of pain management i n prehospital emergency care and to get more information about the adm inistration of analgesics in prehospital patients. Methods: Patients w ith painful diseases or injuries who had been brought to Munich hospit al's were included in the study. Immediately after having reached the hospitals' emergency department, they were ev aluated using a 101-poin t visual analogue scale for the severity of pain at four predefined pe riods. Information about the patient, the diagnosis, and the analgesic treatment used by the emergency teams were drawn from the patient's c hart. Results: A total of 462 patients were included in the study. The mean pain score on arrival of the emergency team was 64 points; 36.5% of the patients were treated with analgesics. In 28.1% the emergency team tried to reduce pain through external measures (i.e., setting of fractures). In 35.3% there was no therapeutic intervention. In cases i n which analgesic therapy was initiated, a definite reduction in pain was achieved during emergency care. Visual analogue scores decreased f rom 70 points at the beginning to 29 points at arrival to the hospital 's emergency department. Analgesics were most frequently used for pati ents with cardiopulmonary diseases (47.2%), followed by patients with traumatic accidents (35.5%) and patients with acute abdominal pain (25 .2%). Of the analgesics, opioids were given mast frequently (87.0%). N onopioid analgesic agents were used in 32.1%. The results of our inves tigation demonstrate that in many cases the administration of analgesi cs is not individualized to the patients needs. Conclusion: During the prehospital period of emergency care many patients suffer from severe pain. The development of patient-oriented concepts concerning pain ma nagement could contribute to improvement of pain therapy in prehospita l emergency medicine.