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Evaluation of the intensity and management of pain before arrival in hospital among patients with suspected hip fractures
Örebro University, School of Health Sciences. Research and Development Centre, Skaraborg Hospital, Skövde, Sweden; University Health Care Research Center, Region Örebro, and School of Health Sciences, Örebro University, Sweden.ORCID iD: 0000-0001-7690-1735
Örebro University, School of Health Sciences. University Health Care Research Center, Region Örebro.ORCID iD: 0000-0003-2411-1795
Research and Development Centre, Skaraborg Hospital, Skövde, Sweden; Institute of Health and Care Sciences and Centre for Person-Centred Care, and Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, Sweden.
Prehospen-Centre of Prehospital Research, Faculty of Caring Science, Work-Life and Social Welfare, University of Borås, Sweden.
2020 (English)In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 49, article id 100825Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Pain management needs to be comprehensively investigated in patients with hip fractures, as it represents a fast-growing challenge to emergency care. The purpose of this study was to describe reported pain in patients with suspected hip fractures in a prehospital setting.

METHODS: In this observational study, 1,426 patients with a suspected hip fracture were included. Dynamic and static pain were assessed on the arrival of the emergency medical services (EMS) and on hospital admission using the Numerical Rating Scale (NRS), if feasible, and the Behaviour Rating Scale (BRS), if not.

RESULTS: On EMS arrival, the median dynamic NRS pain score was eight and 84% of the patients had severe or moderate dynamic pain according to the BRS. On admission to hospital, the median dynamic NRS pain score was reduced to five and 45% of the patients had reduced dynamic pain according to the BRS. Among all patients, the NRS was judged to be feasible and was therefore used in 36%. Furthermore, there was an association between the decrease in pain and the increase in the number of administered medications, as well as the duration of prehospital care.

CONCLUSIONS: Patients with suspected hip fractures suffered substantial pain on EMS arrival. Only half experienced a reduction in pain on hospital admission and only 75% received pain-relieving medication.

Place, publisher, year, edition, pages
Elsevier, 2020. Vol. 49, article id 100825
Keywords [en]
Analgesia, Emergency medical services, Hip fracture, Pain, Pain management, Pain measurement
National Category
Nursing
Identifiers
URN: urn:nbn:se:oru:diva-79933DOI: 10.1016/j.ienj.2019.100825ISI: 000536443000008PubMedID: 32029418Scopus ID: 2-s2.0-85078820433OAI: oai:DiVA.org:oru-79933DiVA, id: diva2:1394787
Note

Funding Agencies:

Research Funds at Skaraborg Hospital  

Skaraborg Institute 

Available from: 2020-02-20 Created: 2020-02-20 Last updated: 2020-06-16Bibliographically approved

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Wennberg, PärMöller, Margareta

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