Pain Assessment and Its Effect on Pain Management During Emergency Medical Services-A Descriptive Study in the...

Pain management is an important part of prehospital care. Pain assessment and recognition are inseparable in adequate pain treatment. However, relatively scarce literature is available from Nordic and European countries. We investigated the current practices of pain assessment and management in the Emergency Medical Service (EMS) of one Finnish hospital area.

The cohort data were originally collected prospectively to assess various quality processes in EMS. This study was designed as a descriptive, retrospective, register-based cohort study, analysing data from 7245 patients encountered by EMS over a one-month period in the Tampere University Hospital area of Finland in 2021. Pain levels were primarily assessed using the numeric rating scale (NRS). Records were combined with auxiliary data from the National Emergency Response Centre Agency. We grouped patients into six age groups and recorded dispatch categories in seven groups to clarify the impact of age and dispatch category on pain assessment and intensity. We used crosstabulation and Pearson's chi-square test for statistical analyses; we also applied a linear mixed model to analyse the effect of pain medication on pain intensity.

Pain was assessed once in 2586 (36%) patients and then reassessed a second time for 707 (27%) of those patients. Age and dispatch category affected pain intensity (p < 0.001): Patients under 66 reported higher pain intensity than patients over 66 years. In dispatch categories, "oxygen deficiency" and "non-mechanical accident or exposure," reported pain intensity was minimal compared to other categories. Of the patients with a pain assessment, 611 (24%) experienced pain equal to or greater than 4 on the NRS scale. We found that assessment with a high NRS level was associated with a higher likelihood of administering potent pain medication.

The prevalence of pain assessment is relatively low. The diverse nature of EMS interventions must be considered when improving pain management strategies.