Abstract
The use of intravenous nalbuphine in pre-hospital settings by paramedics has been demonstrated to be safe and effective. We assessed the effect of this additional intervention by comparing the time spent on-scene by ambulance crews treating patients with fractures of the tibia and fibula who received intravenous nalbuphine with those who had placement of an intravenous cannula alone and those who had neither cannula nor nalbuphine. The mean on-scene times were 17.1 min without cannulation, 29.9 min for cannulation without nalbuphine and 37.5 min for cannulation and administration of nalbuphine. The benefits of effective pre-hospital analgesia thus have a cost in terms of time. Continued audit of interventions and on-scene times is important to prevent inappropriate delays in pre-hospital care which may cause clinical and operational problems.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Border J. R., Lewis F. R., Aprahamian C., Haller J. A., Jacobs L. M., Luterman A. Panel: prehospital trauma care--stabilize or scoop and run. J Trauma. 1983 Aug;23(8):708–711. [PubMed] [Google Scholar]
- Chambers J. A., Guly H. R. Prehospital intravenous nalbuphine administered by paramedics. Resuscitation. 1994 Mar;27(2):153–158. doi: 10.1016/0300-9572(94)90008-6. [DOI] [PubMed] [Google Scholar]
- McSwain G. R., Garrison W. B., Artz C. P. Evaluation of resuscitation from cardiopulmonary arrest by paramedics. Ann Emerg Med. 1980 Jul;9(7):341–345. doi: 10.1016/s0196-0644(80)80108-9. [DOI] [PubMed] [Google Scholar]
- Pons P. T., Moore E. E., Cusick J. M., Brunko M., Antuna B., Owens L. Prehospital venous access in an urban paramedic system--a prospective on-scene analysis. J Trauma. 1988 Oct;28(10):1460–1463. doi: 10.1097/00005373-198810000-00009. [DOI] [PubMed] [Google Scholar]
- Rouse A. Do ambulance crews triage trauma patients? Arch Emerg Med. 1991 Sep;8(3):185–191. doi: 10.1136/emj.8.3.185. [DOI] [PMC free article] [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]
- Trunkey D. D. Is ALS necessary for pre-hospital trauma care? J Trauma. 1984 Jan;24(1):86–87. doi: 10.1097/00005373-198401000-00017. [DOI] [PubMed] [Google Scholar]
- Werman H. A., Nelson R. N., Campbell J. E., Fowler R. L., Gandy P. Basic trauma life support. Ann Emerg Med. 1987 Nov;16(11):1240–1243. doi: 10.1016/s0196-0644(87)80231-7. [DOI] [PubMed] [Google Scholar]