[Evaluation of acute pain in prehospital medicine].
OBJECTIVE
To evaluate acute pain in prehospital setting.


METHODS
Prospective survey.


METHODS
All eligible patients during a 3-month-period, excepted children less than 10-year-old.


METHODS
Pain intensity was evaluated by verbal rating scale with 5 points (VRS), visual analog scale (VAS), demand for antalgics by the patient and the relief obtained. These data were collected at the beginning (T0) and the end (Tend) of medical management. Analgesic treatments were let at the physician's choice.


RESULTS
A series of 255 patients were included (mean age 58 +/- 1.5 SEM, sex-ratio 57M/43F). Among them, 42% experienced pain at VRS. VAS could be used in 60% of patients. VRS evaluated by the patient was correlated to the VAS (P < 0.001). Among those with significant pain (defined by a VAS > or = 30 mm), only 31% asked for analgesia and 64% received analgesics. Pain scales (VRS and VAS) were significantly improved (P < 0.001) at the end of the medical management, except for patients who did not receive any treatment. However, mean VAS was still above 30 mm, even in patients receiving analgesics. Only 49% of patients expressed a good relief at the end of the medical management.


CONCLUSIONS
Acute pain is frequently observed in prehospital emergency medicine. Pain scales such as VRS and VAS are used easily and convenient for the assessment of pain intensity in this context. However, even if pain is correctly evaluated, it is still inadequately treated. The reasons of these inadequacies must be assessed and corrected with pain treatment protocols including opioids.
Ricard-Hibon
A
A
Smur Beaujon, service d'anesthésie-réanimation, hôpital Beaujon, France.
Leroy
N
N
Magne
M
M
Leberre
A
A
Chollet
C
C
Marty
J
J
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000698:Analgesia; D003625:Data Collection; D003953:Diagnosis-Related Groups; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis* / Q000188:drug therapy; D010147:Pain Measurement; D017060:Patient Satisfaction; D011446:Prospective Studies