ANALGESIA IN THE ACCIDENT AND EMERGENCY DEPARTMENT - DO SHOS HAVE THEKNOWLEDGE TO PROVIDE OPTIMAL ANALGESIA

Objective - To assess senior house officers' knowledge in prescribing emergency analgesia for acute presentations in the accident and emerge ncy (A&E) department. Design - Prospective telephone survey of a defin ed population of SHOs, using a standardised structured questionnaire, in the months of October and November, 1995; 231 SHOs from 215 A&E dep artments were interviewed. The questionnaire required responses to hyp othetical scenarios. A six member expert panel from the local region w as consulted for suggestions for appropriate responses. Main outcome m easures - Comparisons between SHO responses and those of an expert pan el. Results - For choice of analgesic agent, 83% of SHO responses were appropriate, for route of administration 57%, and for the dose of dru g 34%. The scenario with the best overall response was a sprained ankl e. The paediatric case with partial burns faired worse. Responses to a myocardial infarction scenario were the most consistent. Conclusions - A&E SHOs lack knowledge and confidence when asked to prescribe emerg ency analgesia for acute conditions. Responses to certain scenarios we re extremely varied, indicating a need for national analgesia guidelin es and protocols. Recognised training in pain management should be mor e readily available.