| Title | What is the ideal pre-hospital analgesic?--a questionnaire study. | | Author(s) | Smith JE, Russell R, Mahoney PF, Hodgetts TJ | | Institution | Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine. | | Source | J R Army Med Corps 2009 Mar; 155(1):44-6. | | Abstract | AIM: To determine clinical opinion of effectiveness of current battlefield analgesia and the realistic options to improve future analgesia in hostile environments.
METHODS: Structured electronic questionnaire distributed to selected individuals in UK and on operations.
POPULATION: 122 UK Defence Medical Services and US Medical Corps doctors, nurses and combat medical technicians involved in the early management of severe trauma on deployment.
RESULTS: 54 (44%) agreed and 63 (52%) disagreed that intramuscular morphine had the ideal analgesic properties for the military pre-hospital environment. Over half of those with operational experience reported multiple instances of intramuscular morphine providing inadequate analgesia. 86 (70%) desired a more potent analgesic than morphine in the first hour following injury. 101 (83%) identified simplicity and reliability of use by a soldier as of high importance. 99 (81%) identified rapid onset of action of high importance. With regard to an acceptable route of drug self-administration, 88 (72%) supported a nasal spray; 78 (64%) supported a sustained release buccal tablet (adhesive to the gum); 61 (50%) supported a disposable inhaler of volatile gas (although 91% had no experience of the currently available drug in this formulation); and 55 (45%) supported a skin patch.
CONCLUSION: Intramuscular morphine does not meet the needs of the majority of clinical stakeholders. Alternative routes of self-administration are acceptable, but support for available commercial solutions is clouded by incomplete awareness. Anaesthetists and emergency physicians desire a multimodal approach to battlefield analgesia within the evacuation chain. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 19817091 |
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