Spotlight on Research

Undertaken in Melbourne, Australia, this study examines whether a patient's gender influences the provision of analgesia in prehospital settings. A retrospective review of patient care records identified 1766 patients eligible for inclusion in this part of the study. The median age of the sample was 61 years and 52% were female. The results indicate that in 95% of cases paramedics documented a pain assessment, and that a Numeric Rating Scale (NRS) was the most frequently used assessment tool (71% of cases). Of those patients reporting pain, 45% did not receive analgesia but there was no significant difference between the sexes (P=0.93). Overall, fewer males reported severe pain (indicated as 8–10 on the NRS) than females. The findings revealed a significant difference in relation to what type of analgesia was administered, with fewer females receiving morphine (13% 95% CI, 11–15% P=0.01). There are some limitations to the study as it was retrospective which, among other things, restricts opportunities to check the accuracy of documentation; also the research only includes one ambulance service which may limit its generalizability. However, studies such as this contribute to a raised awareness of the diversity of issues which may contribute to effective pain management. Future prospective research must further examine factors influencing paramedics' clinical decision-making during the management of patients' pain.

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