Pain: understanding the biopsychosocial model and the paramedic's role within the multi-disciplinary team

Pain, and its consequent management, is a major factor in today's ambulance service, with up to 50% of patients reporting pain among their symptoms when contacting the emergency service (Hawkes-Frost, 2014). Pain management is one of the key responsibilities for all clinicians working in health care, and paramedics have a duty of care to ensure that it is managed effectively, ethically, and in line with local and national guidelines (Peate, 2011). This has been recognised by many ambulance Trusts and has led to various initiatives in order to: first, better treat the pain (through the introduction of more appropriate and more effective analgaesics), and second, be more efficient with the deployment of resources (with the introduction of specialist pain paramedics and guidelines to treat within the multi-modal model). Unfortunately, there are still large inconsistencies between the different ambulance Trusts and in the subsequent curriculums of the associated universities that supply the next generation of paramedics. This has led to a leading expert in pre-hospital analgaesia to state that there is a ‘low priority placed on pain assessment and management…for many pre- and out-of-hospital health professionals’ (Hawkes-Frost, 2014). Hence, as the ambulance service continues in its transformation from a primarily emergency care role and into the realms of community urgent care, the need to understand the biopsychosocial model and the role that paramedics play within the multi-disciplinary team has become apparent.