Pain Assessment and Pain Alleviation Practices of Ambulance Officers in Auckland

Abstract

Pain is a common complaint of many patients that ambulance officers encounter. The prevalence of pain in Auckland is unknown. Little is known about how ambulance officers and paramedics assess and treat pain. More options exist for treating pain than previously, but frequency of use is uncertain. A retrospective review of ambulance officer patient report forms was carried out (n=371). Patient information including age, gender, chief complaint, and acuity status were recorded. Presence, location and pain assessment variables, including pain scores were abstracted. Documented treatment of pain was also recorded. Crew qualifications were abstracted. Research questions were targeted towards the prevalence of pain, methods and frequency of pain assessment used, pharmacological and non-pharmacological treatment of pain, and if differences existed in how ambulance officers of different qualifications assessed and treated pain. Pain was reported in 49% of patients. Chest (21%) and abdominal (19%) pain were most common. Ten percent of patients had an initial pain scores documented, the mean pain score being 6.04. Mean follow-up pain score was 2.83. Poor documentation of onset, provokes, quality, radiation, severity, timing and pain scores was evident. Paracetamol was the most frequently administered analgesic (19%). Poor documentation of non-pharmacological treatment noted. Basic life support officers recorded some pain assessments more frequently than other qualifications, but intermediate life support officers recorded pain scores more than others did. Poor documentation about pain assessment and treatment of pain exists. There are opportunities for further education of ambulance officers, especially assessment of pain in paediatric and cognitively impaired patients. Consideration should be given to assessing the patient’s desire for analgesia. This study provides a baseline for future comparison.