Paramedic attitudinal profiles regarding pediatric pain management: A latent class analysis in a standardized emergency medical services system

Pediatric pain is frequently under-recognized and undertreated in prehospital emergency care despite guideline-based recommendations, and practice variation may persist even within standardized emergency medical services (EMS) systems.

We conducted a prospective, cross-sectional survey of paramedics working in a nationally standardized EMS system in Türkiye to identify latent attitudinal (self-reported) profiles related to pediatric prehospital analgesia and to examine whether profile membership differed by demographic or professional characteristics. Attitudinal items underwent exploratory dimensionality assessment and were then modeled using latent class analysis.

Among 129 paramedics, two profiles were identified: proactive/system-oriented (57.4%) and conservative/low-engagement (42.6%). The proactive/system-oriented profile reported higher endorsement of decision-support tools (mobile drug-dosing applications and in-ambulance analgesia algorithms), more consistent self-reported post-analgesia vital sign monitoring, and greater self-reported use of non-pharmacologic adjuncts. The conservative/low-engagement profile reported lower intended engagement with these self-reported practices and greater reliance on perceived barriers. Profile membership was not associated with age, sex, years of EMS experience, or prior training.

Distinct attitudinal (self-reported) profiles regarding pediatric prehospital analgesia were identified; whether these profiles translate into objectively observed analgesia delivery requires validation using routine documentation and, where feasible, linked ED outcomes.