References
Considerations on out-of-hospital pain assessment of a diverse population
Abstract
Nearly all medical emergency calls are related to someone experiencing some form of discomfort—either due to trauma or pain. Initial pain assessment may be undertaken over the telephone by an emergency medical dispatcher, without seeing the patient; however, the next key moment in pain assessment is completed patient-side by the paramedic. This inquiry is detailed and guides the paramedic in the formation of a differential diagnosis and provision of appropriate pain management. The research team recently conducted and published a study on pain assessment which raised concerns on the subjectivity of pain scoring. The work presented was in the context of a very multicultural environment. The aim of this commentary article is to further explore this topic and encourage health professionals to reflect on this aspect of patient assessment.
Pain is often the trigger that makes people call for an ambulance (Armour and Murphy-Jones, 2016) and alleviating pain and suffering is one of the first goals of a paramedic upon meeting a patient. However, as easy as it sounds, many factors affect pain perception and reporting on the part of patients, and how the paramedic will deal with the situation (Lord et al, 2014; Siriwardena et al, 2019). Pain assessment is not only a difficult aspect of patient care in the prehospital setting (Lynde and Zorab, 2015), as it is also reported as a challenge to consistently perform and document in emergency departments (Mazara et al, 2016). Although pain is a very subjective parameter, it is important that the paramedic appropriately assesses pain and documents it accordingly. This is the first step in appropriate pain management and alleviation. Other factors to consider include the paramedic's scope of practice and legal aspects associated with the use of analgesic and pain medication. Controlled medication may be potentially lethal if inappropriately administered (Hodkinson, 2016). These elements may further influence or impede the decision-making process of paramedics in determining what pain relief option to adopt.
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