title: Incidence, characteristics and management of pain in one operational area of medical emergency teams.
abstract: BACKGROUND
  Experience of pain associated with both chronic as well as acute medical conditions is a main cause for call for ambulance. The aim of this study was to establish both frequency and characteristics of pain reported by patients treated in pre-hospital environment in a single operational area. The supplementary goal was an analysis of methods of pain alleviation applied by medical personnel in the above described scenario.
  
  
  METHODS
  The written documentation of 6 months of year 2009 provided by doctor-manned as well as paramedic-only ambulances operating in Tatra county, Małopolska, Poland was analyzed.
  
  
  RESULTS
  Medical personnel inquired about pain experienced in 57.4% of cases, 10-point numerical rating scale was used in 22.3% of patients. Pain was reported by 43.8% of patients, the most frequent reasons of experienced pain were trauma and cardiovascular diseases. In almost half of the cases pain was referred to the areas of chest and abdomen. Non-traumatic pain was reported by 47.7% of patients, post-traumatic in 41.3% of cases, 11% of subjects reported ischemic chest pain. 42.3% of pain-reporting patients received some form of analgesia, yet only 3% of subjects in this group received opiates. Personnel of paramedic-only ambulances tended to use pain intensity scale more often (P < 0.01), yet administered pain alleviating drugs noticeably less often than the doctor-manned teams (P < 0.01).
  
  
  CONCLUSIONS
  The use of pain alleviating drugs, opiates especially, was inadequate in proportion to frequency and intensity of pain reported by patients. General, nation-wide standards of pain measurement and treatment in pre-hospital rescue are suggested as a means to improve the efficacy of pain reduction treatment.
authors.affiliation: Department of Anaesthesiology and Intensive Therapy, Sokołowski Specialist Hospital of Lung Diseases in Zakopane, Poland. kosa@mp.pl.
authors.forename: Sylweriusz
authors.initials: S
authors.lastname: Kosiński
authors.forename: Magdalena
authors.initials: M
authors.lastname: Bryja
authors.forename: Rafał
authors.initials: R
authors.lastname: Wojtaszowicz
authors.forename: Andrzej
authors.initials: A
authors.lastname: Górka
mesh_terms: D000328:Adult; D000368:Aged; D000552:Ambulances / Q000458:organization & administration / Q000706:statistics & numerical data; D000698:Analgesia / Q000379:methods; D000700:Analgesics / Q000008:administration & dosage; D000701:Analgesics, Opioid / Q000008:administration & dosage; D004632:Emergency Medical Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D010348:Patient Care Team / Q000458:organization & administration*; D011044:Poland; D012189:Retrospective Studies
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid