Is there scope for an observational pain scoring tool in paramedic practice?

Population ageing has grown steadily year on year, with estimations suggesting those aged 65 years and over will account for 23% of the total population of the United Kingdom by 2035 (Office for National Statistics, 2013). An ageing population clearly has an effect on healthcare provision, leading the government, along with health authorities to release a plethora of guidelines and advice for almost all aspects of care for the older person. These are aimed at health professionals from all backgrounds to ensure the care delivered to the older person is effective, evidence based and good value. In the UK a major provider of guidelines is the National Institute for Health and Care Excellence. The ‘Silver Book’ is also another source of reference for health professionals, with its sole focus being on older people.

In the pre-hospital environment, attending an older person can pose many challenges, including a lack of a detailed history, polypharmacy and co-morbidities, as well as a lack of out-of-hours support to name but a few. These challenges are enhanced further when the patient is cognitively impaired by syndromes such as dementia.