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Prehospital smärtbehandling till barn och vuxna med smärta i buk/flank eller arm/hand. En retrospektiv journalstudie
Umeå University, Faculty of Medicine, Department of Nursing.
Umeå University, Faculty of Medicine, Department of Nursing.
2013 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
Abstract [en]

Purpose; To examine how children's pain is treated in prehospital care as compared with pain in adult patients in Västerbottens county councils.

Method/ Design; A retrospective study based on Västerbottens county council's ambulance record database Paratus was performed during the period 2011-09-01 - 2012-09-01. In total 164 patients were included, 82 children (age 0- 15 years) and 82 adults (> 15 years). Data on gender, age, if the pain was assessed, pain treatment, vital signs and the processing time was collected from Paratus.

Results; Pain was not assessed in the majority of the participants (76.2 %) in pre-hospital care. Children’s pain was assessed to a lower extent than in adults (p= 0.006) in the group of children with an injury in an arm / hand (p = 0.025). Overall, pain medication was administrated to the same extent in children and adults, but in the group with pain in abdomen-/flank the children received pain treatment to a lower extent than in adults. The same drugs and combinations of analgesics were administrated independent of contact cause and age but adults received opioids more often than children. Vital signs were registered to the same extent in children and adults, and the processing time did not differ in any of the groups.

Conclusion; In line with previous research, this study reveals an image of flawed prehospital pain assessment wich could lead to inadequate pain treatment. Children's pain was assessed less frequent than adults and adults received more potent analgesics. Pain management competence in prehospital care should be increased, in particular, this applies to pain management in children.

Abstract [sv]

Abstrakt

Syfte; Att undersöka hur barns smärta behandlas prehospitalt jämfört med prehospital smärta hos vuxna patienter i Västerbottensläns landsting.

Metod/ Design; En retrospektiv journalstudie utifrån Västerbottens läns landstings ambulansjournaldatabas Paratus gjordes under perioden 2011-09-01 - 2012-09-01. Totalt inkluderades 164 patienter, 82 barn (ålder 0-15 år) och 82 vuxna (> 15 år). Data om kön, ålder, smärtskattning, smärtbehandling, vitalparametrar och behandlingstid insamlades från Paratus.

Resultat; Majoriteten av deltagarna (76.2 %) smärtskattades inte vid det prehospitala omhändertagandet och barn smärtskattades i lägre utsträckning än vuxna (p=0.006). Skillnaden var signifikant i gruppen barn och vuxna där kontaktorsaken var skada i arm/hand (p=0.025) men inte i gruppen där kontaktorsak var smärta i buk/flank. Sammantaget gavs smärtbehandling i samma omfattning till barn och vuxna, men vid buk-/flanksmärta i erhöll barn smärtbehandling i lägre utsträckning än vuxna. Samma läkemedel och kombinationer av analgetika gavs oberoende av kontaktorsak och ålder men vuxna erhöll opiater i högre utsträckning än barn. Vitalparametrar var registrerade i samma omfattning hos barn och vuxna och behandlingstiden skiljde sig inte åt i någon av de jämförda grupperna.

Slutsats; I linje med tidigare forskning framkommer det en bild av att bristfällig prehospital smärtskattning vilket riskerar att leda till bristfällig smärtbehandling. Barn smärtskattades i lägre omfattning än vuxna och vuxna erhöll oftare potenta analgetika. Smärtbehandlingskompetens inom prehospital omvårdnad bör ökas, särskilt gäller detta smärtbehandling till barn.

Place, publisher, year, edition, pages
2013. , p. 24
Keywords [en]
Pain, prehospital care, children, pain assessment, pain management.
Keywords [sv]
Smärta, prehospital omvårdnad, barn, smärtskattning, smärtbehandling
National Category
Nursing
Identifiers
URN: urn:nbn:se:umu:diva-88451OAI: oai:DiVA.org:umu-88451DiVA, id: diva2:715728
Educational program
Graduate Programme in Prehospital Nursing
Supervisors
Examiners
Available from: 2014-05-06 Created: 2014-05-06 Last updated: 2014-05-06Bibliographically approved

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CiteExportLink to record
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Citation style
  • apa
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