NDLI: The impact of patient sex on paramedic pain management in the prehospital setting.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Lord, Bill Cui, James Kelly, Anne-Maree
Spatial Coverage	Australia
Description	Country affiliation: Australia Author Affiliation: Lord B ( Department of Community Emergency Health and Paramedic Practice, Monash University, Victoria 3800, Australia. bill.lord@med.monash.edu.au)
Abstract	OBJECTIVE: The aim of this study was to establish the impact of patient sex on the provision of analgesia by paramedics for patients reporting pain in the prehospital setting. METHODS: This retrospective cohort study of paramedic patient care records included all adult patients with a Glasgow Coma Score higher than 12 transported to hospital by ambulance in a major metropolitan area over a 7-day period in 2005. Data collected included demographics, patient report of pain and its type and severity, provision of analgesia by paramedics, and type of analgesia provided. The outcomes of interest were sex differences in the provision of analgesia. Data analysis was by descriptive statistics, chi2 test, and logistic regression. RESULTS: Of the 3357 patients transported in the study period, 1766 (53%) reported pain; this forms the study sample. Fifty-two percent were female, median age was 61 years, and median initial pain score (on a 0-10 verbal numeric rating scale) was 6. Forty-five percent of patients reporting pain did not receive analgesia (791/1766) (95% confidence interval [CI], 43%-47%), with no significant difference between sexes (P = .93). There were, however, significant sex differences in the type of analgesia administered, with males more likely to receive morphine (17%; 95% CI, 15%-20%) than females (13%; 95% CI, 11%-15%) (P = .01). The difference remains significant when controlled for type of pain, age, and pain severity (odds ratio, 0.61, 95% CI, 0.44-0.84). CONCLUSION: Sex is not associated with the rate of paramedic-initiated analgesia, but is associated with differences in the type of analgesia administered.
File Format	HTM / HTML
ISSN	07356757
Issue Number	5
Volume Number	27
e-ISSN	15328171
Journal	The American Journal of Emergency Medicine
Language	English
Publisher	Elsevier
Publisher Date	2009-06-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Emergency Discipline Medicine Analgesics, Opioid Administration & Dosage Emergency Medical Services Morphine Pain Drug Therapy Adolescent Adult Aged Aged, 80 And Over Australia Chi-square Distribution Female Glasgow Coma Scale Humans Logistic Models Male Middle Aged Pain Measurement Retrospective Studies Sex Factors Journal Article
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine

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