Fentanyl trauma analgesia use in air medical scene transports.
This study assessed frequency, safety and efficacy of prehospital fentanyl analgesia during 6 months' adult and pediatric helicopter trauma scene transports (213 doses in 177 patients). We reviewed flight records for pain assessment and analgesia provision, effect, and complications. Analgesia was administered to 46/49 (93.9%) intubated patients. In non-intubated patients, pain assessment was documented in 112 of 128 (87.5%), and analgesia was offered, or there was no pain, in 97/128 (75.8%). Of the 67 non-intubated patients to whom analgesia was administered, post-analgesia pain assessment was documented in 62 (92.5%) and pain improved in 53 (79.1% of 67). Post-analgesia blood pressure dropped below 90 torr in 2/177 cases (1.1%, 95% confidence interval [CI] 0.1-4.0%). Post-analgesia S(p)O(2) did not drop below 90% in any patients (95% CI 0-2.3%). In this study, prehospital providers performed well with respect to pain assessment and treatment. Fentanyl was provided frequently, with good effect and minimal cardiorespiratory consequence.
Thomas
Stephen H
SH
Boston MedFlight, Boston, Massachusetts, USA.
Rago
Oscar
O
Harrison
Tim
T
Biddinger
Paul D
PD
Wedel
Suzanne K
SK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017732:Air Ambulances / Q000706:statistics & numerical data*; D000698:Analgesia / Q000379:methods / Q000706:statistics & numerical data*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004282:Documentation / Q000706:statistics & numerical data; D004305:Dose-Response Relationship, Drug; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use*; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D007223:Infant; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D010147:Pain Measurement / Q000706:statistics & numerical data; D012131:Respiratory Insufficiency / Q000139:chemically induced; D014947:Wounds and Injuries / Q000150:complications*
D000701:Analgesics, Opioid; D005283:Fentanyl