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

Lord, Bill, Cui, James and Kelly, Anne-Maree 2009, The impact of patient sex on paramedic pain management in the prehospital setting, American journal of emergency medicine, vol. 27, pp. 525-529, doi: 10.1016/j.ajem.2008.04.003.

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Title The impact of patient sex on paramedic pain management in the prehospital setting
Author(s) Lord, Bill
Cui, James
Kelly, Anne-Maree
Journal name American journal of emergency medicine
Volume number 27
Start page 525
End page 529
Publisher W.B. Saunders
Place of publication Philadelphia, Pa.
Publication date 2009
ISSN 0735-6757
Summary 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, χ2 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.

Language eng
DOI 10.1016/j.ajem.2008.04.003
Field of Research 111799 - Public Health and Health Services not elsewhere classified
Socio Economic Objective 920499 Public Health (excl. Specific Population Health) not elsewhere classified
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2009, Elsevier
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