Abstract
Many patients arrive at the accident and emergency (A&E) department in pain. To quantify this problem a retrospective analysis was performed of the clinical records of 502 consecutive patients arriving by ambulance at the A&E department over a 20-day period. A total of 273 (54%) of the patients had pain as a symptom on arrival and 69 (14%) were given opioid analgesia in the A&E department. Sixty of those given opioids had a single limb fracture. A survey of all ambulance services in the U.K. was conducted by means of a postal questionnaire sent to chief ambulance officers. Only five out of 65 services give any analgesia other than Entonox (B.O.C.). There were wide variations in the attitudes of services around the country to future developments. The authors suggest that paramedics should be trained to administer intravenous opioid analgesia.
Full text
PDF





Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Baskett P. J. Use of Entonox in the ambulance service. Br Med J. 1970 Apr 4;2(5700):41–43. doi: 10.1136/bmj.2.5700.41. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fagbemi O., Kane K. A., Leprán I., Parratt J. R., Szekeres L. Antiarrhythmic actions of meptazinol, a partial agonist at opiate receptors, in acute myocardial ischaemia. Br J Pharmacol. 1983 Mar;78(3):455–460. doi: 10.1111/j.1476-5381.1983.tb08805.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gal T. J., DiFazio C. A., Moscicki J. Analgesic and respiratory depressant activity of nalbuphine: a comparison with morphine. Anesthesiology. 1982 Nov;57(5):367–374. doi: 10.1097/00000542-198211000-00004. [DOI] [PubMed] [Google Scholar]
- Mathewson Z. M., McCloskey B. G., Evans A. E., Russell C. J., Wilson C. Mobile coronary care and community mortality from myocardial infarction. Lancet. 1985 Feb 23;1(8426):441–444. doi: 10.1016/s0140-6736(85)91156-0. [DOI] [PubMed] [Google Scholar]
- Stene J. K., Stofberg L., MacDonald G., Myers R. A., Ramzy A., Burns B. Nalbuphine analgesia in the prehospital setting. Am J Emerg Med. 1988 Nov;6(6):634–639. doi: 10.1016/0735-6757(88)90109-x. [DOI] [PubMed] [Google Scholar]
- Trouton T. G., Adgey A. A. High dose nalbuphine in early acute myocardial infarction. Int J Cardiol. 1989 Apr;23(1):53–57. doi: 10.1016/0167-5273(89)90329-x. [DOI] [PubMed] [Google Scholar]
- Weston C., Goodall K., Stephens M. Variations in the provision of extended-trained ambulance personnel within the Welsh ambulance services. Health Trends. 1990;22(3):121–124. [PubMed] [Google Scholar]
