Paediatric prehospital analgesia in Auckland.
OBJECTIVE
The objectives of the present study were: To determine whether the age of a child influences the likelihood of their receiving prehospital analgesia from the Auckland ambulance service. To investigate the effect of age on ambulance officers' decision-making and use of analgesia.


METHODS
A prospective study of children arriving by ambulance at Starship Children's Emergency Department Auckland, with a diagnosis of limb fracture or burn, was undertaken over 2 months in 2002. A concurrent questionnaire survey investigated ambulance officers' use of analgesia in children.


RESULTS
No child aged less than 5 years (n = 10) compared with 51% between 5 and 15 years of age (n = 35) received prehospital analgesia (P = 0.003). On arrival in hospital 70% aged less than 5 years compared with 54% older than 5 years required i.v. opiate analgesia. Ambulance officers did not perceive that a child's age would significantly alter their decision to use analgesia.


CONCLUSIONS
In children, younger age is a significant risk factor for receiving inadequate prehospital analgesia. Ambulance officers' concern about the pain of injection is the major identified factor for the relative underuse of morphine observed in younger children.
Watkins
Nicholas
N
Children's Emergency Department, Starship Hospital, Auckland, New Zealand. nicholasw@adhb.govt.nz
D000082:Acetaminophen / Q000627:therapeutic use; D000293:Adolescent; D000367:Age Factors; D000698:Analgesia / Q000706:statistics & numerical data*; D000700:Analgesics / Q000627:therapeutic use; D002056:Burns / Q000150:complications; D002648:Child; D002675:Child, Preschool; D004333:Drug Administration Routes; D004632:Emergency Medical Services / Q000379:methods / Q000706:statistics & numerical data*; D004634:Emergency Medical Technicians / Q000706:statistics & numerical data; D050723:Fractures, Bone / Q000150:complications; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009020:Morphine / Q000627:therapeutic use; D009520:New Zealand; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D010372:Pediatrics / Q000379:methods / Q000706:statistics & numerical data*; D011446:Prospective Studies
D000700:Analgesics; D000082:Acetaminophen; D009020:Morphine