title: [Physician staffed ambulances are better for patients' analgesia on arrival at the emergency department].
abstract: OBJECTIVE
  To find out prehospital factors linked with low pain on arrival into a traumatic emergency unit.
  
  
  METHODS
  A 4-month monocentric prospective study, including patients recruited at their arrival into a traumatic emergency unit. Pain (with a numerical rating scale [NRS]), anxiety, prehospital care including the type of transportation (physician staffed ambulances {service mobile d'urgence et de réanimation [Smur]}, emergency medical technicians, or firemen ambulances), immobilization and analgesics used were evaluated. These data were collected on arrival at the hospital by the ED orientation nurse. Uni- and multivariate analysis were performed to identify low pain's predictive factors (e.g. with a NRS ≤3).
  
  
  RESULTS
  Three hundred and four patients were recruited, mean age=51±25, sex ratio=1.8, mean pain/10=5.8±2.9, 64% with a moderate or severe pain on arrival (NRS>3). For one third of patients, immobilizations hadn't been performed during the prehospital phase. Medical management by Smur is a low pain predictive factor (OR=5.8; CI 95%=1.4-24.16), anxiety is a pejorative factor (OR=0.53 CI 95%=0.38-0.75).
  
  
  CONCLUSIONS
  Our study highlights the physician staffed ambulances' effectiveness in prehospital trauma victims' management and raises the question of anxiolysis as an adjuvant for traumatic pain management.
authors: Pôle de médecine d'urgences, hôpitaux universitaires de Toulouse, place du Dr-Baylac, Toulouse cedex 9, France. bounes.v@chu-toulouse.fr
authors: V
authors: V
authors: Bounes
authors: F
authors: F
authors: Concina
authors: N
authors: N
authors: Lecoules
authors: M
authors: M
authors: Olivier
authors: D
authors: D
authors: Lauque
authors: J-L
authors: JL
authors: Ducassé
mesh_terms: D000328:Adult; D000368:Aged; D000552:Ambulances; D000698:Analgesia / Q000592:standards*; D004635:Emergency Medicine; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies