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Pain in the Prehospital Setting in Rwanda: Results of a Mixed-Methods Quality Improvement Project
A Rosenberg1, E Uwitonze2, M Dworkin3
1Department of Surgery, Virginia Commonwealth University, School of Medicine, Richmond, VA, USA.
Pain Research & Management
|October 5, 2020
Summary
This study assessed pain management by the Rwanda prehospital ambulance service (SAMU). Findings revealed that 55% of patients reported pain, but only 45% received medication, highlighting a need for standardized pain management guidelines.
Area of Science:
- Emergency Medicine
- Prehospital Care
- Quality Improvement
Background:
- Pain management is crucial in emergency settings but often lacks standardization.
- The SAMU ambulance service in Kigali, Rwanda, lacked prehospital pain management guidelines.
- Assessing current practices is essential for developing evidence-based protocols.
Purpose of the Study:
- To evaluate the quality of pain management within the SAMU ambulance service.
- To understand how ambulance staff assess and treat pain in prehospital emergencies.
- To facilitate the development of standardized pain management guidelines for prehospital care.
Main Methods:
- A two-step quality improvement project was conducted.
- Analysis of deidentified ambulance service records (December 2012 - May 2016).
- Semistructured interviews with SAMU staff until thematic saturation.
Main Results:
- Over 11,000 patients managed; 55% reported pain, 45% received pain medication.
- Men had significantly higher odds of receiving pain medication compared to women.
- Staff reported using informal and some standardized methods for pain assessment.
Conclusions:
- The study reviewed existing pain management quality and staff perceptions.
- Results informed the development of context-specific guidelines for prehospital pain management.
- Standardization of prehospital pain management was facilitated in Kigali, Rwanda.
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