Where is the paramedic profession going with pain management?

Pain management is a contemporary issue in pre-hospital care, with a multitude of opinions, evidence and experiences of both clinicians and patients. In recent years, the development of specialist paramedic roles and changes in laws relating to the control of drugs has seen advances in the array of analgesic options available to paramedics. There continues to be myths and anonymity around analgesia, together with regional variances in the analgesic options available. This article explores some of the myths surrounding pain management, the current pre-hospital practices and the evolving options for the future of paramedic practice. This article focuses on pain management in the adult population, due to differences in assessment and management of pain, and the analgesic options available for paediatric patients. However, the principles of pain management remain the same for any patient, regardless of age, gender or ethnicity.

As defined in the Oxford Dictionary, pain is a ‘highly unpleasant physical sensation caused by illness or injury’ (Stevenson, 2010). This is further compounded by Jones and Machen (2003) who identify pain as an unpleasant physical and emotional experience. The physiological processes which cause a person to experience pain are complex and vary from person to person, with a number of variable influencing factors (Parker and Rodgers, 2015). This article does not consider the detailed physiological processes or causative factors associated with pain, nor the severity of pain from patient to patient.