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dc.contributor.authorSiriwardena, A. Niroshan
dc.contributor.authorAsghar, Zahid B.
dc.contributor.authorLord, Bill
dc.contributor.authorPocock, Helen
dc.contributor.authorPhung, Viet-Hai
dc.contributor.authorFoster, Theresa
dc.contributor.authorWilliams, Julia
dc.contributor.authorSnooks, Helen A.
dc.date.accessioned2018-08-16T00:17:53Z
dc.date.available2018-08-16T00:17:53Z
dc.date.issued2019-02
dc.identifier.citationSiriwardena , A N , Asghar , Z B , Lord , B , Pocock , H , Phung , V-H , Foster , T , Williams , J & Snooks , H A 2019 , ' Patient and clinician factors associated with prehospital pain treatment and outcomes: cross sectional study ' , American Journal of Emergency Medicine , vol. 37 , no. 2 , pp. 266-271 . https://doi.org/10.1016/j.ajem.2018.05.041
dc.identifier.issn0735-6757
dc.identifier.otherORCID: /0000-0003-0796-5465/work/62748016
dc.identifier.urihttp://hdl.handle.net/2299/20455
dc.descriptionCopyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.
dc.description.abstractObjective: We aimed to identify how patient (age, sex, condition) and paramedic factors (sex, role) affected prehospital analgesic administration and pain alleviation. Methods: We used a cross-sectional design with a 7-day retrospective sample of adults aged 18 years or over requiring primary emergency transport to hospital, excluding patients with Glasgow Coma Scale below 13, in two UK ambulance services. Multivariate multilevel regression using Stata 14 analysed factors independently associated with analgesic administration and a clinically meaningful reduction in pain (≥2 points on 0–10 numerical verbal pain score [NVPS]). Results: We included data on 9574 patients. At least two pain scores were recorded in 4773 (49.9%) patients. For all models fitted there was no significant relationship between analgesic administration or pain reduction and sex of the patient or ambulance staff. Reduction in pain (NVPS ≥2) was associated with ambulance crews including at least one paramedic (odds ratio [OR] 1.52, 95% confidence interval [CI] 1.14 to 2.04, p < 0.01), with any recorded pain score and suspected cardiac pain (OR 2.2, 95% CI 1.02 to 4.75). Intravenous morphine administration was also more likely where crews included a paramedic (OR 2.82, 95% CI 1.93 to 4.13, P < 0.01), attending patients aged 51 to 64 years (OR 2.04, 95% CI 1.21 to 3.45, p = 0.01), in moderate to severe (NVPS 4–10) compared with lower levels of pain for any clinical condition group compared with the reference condition. Conclusion: There was no association between patient sex or ambulance staff sex or grade and analgesic administration or pain reduction.en
dc.format.extent6
dc.format.extent675601
dc.format.extent34665
dc.language.isoeng
dc.relation.ispartofAmerican Journal of Emergency Medicine
dc.subjectAnalgesia, pain, paramedic, ambulance
dc.subjectEmergency medical services
dc.subjectPrehospital
dc.subjectEmergency Medicine
dc.titlePatient and clinician factors associated with prehospital pain treatment and outcomes: cross sectional studyen
dc.contributor.institutionSchool of Health and Social Work
dc.contributor.institutionAllied Health Professions
dc.contributor.institutionParamedic Science
dc.contributor.institutionCentre for Applied Clinical, Health and Care Research (CACHE)
dc.contributor.institutionCentre for Future Societies Research
dc.description.statusPeer reviewed
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85047753352&partnerID=8YFLogxK
rioxxterms.versionofrecord10.1016/j.ajem.2018.05.041
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue


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