Abstract
BackgroundEmergency Centres (ECs) have a prominent trauma burden requiring effective pain management. This study aimed to review analgesia-prescribing habits in minor trauma, reviewing the patient demographics and diagnoses, analgesia-prescribing habits of health care professionals (HCPs) managing these cases, and differences in prescribing noted by patients’ age group, gender and triage code.MethodsA prospective, cross-sectional, descriptive study was conducted in a regional EC in KwaZulu-Natal. HCPs managing minor trauma patients completed a closed-ended questionnaire which indicated the patients’ demographics, diagnosis and analgesia prescribed.ResultsThe study comprised of 314 cases of which the demographic most represented were male patients aged between 20–30 years with soft tissue injuries. Simple analgesics and weak opioids (paracetamol, ibuprofen and tramadol) accounted for 87.9% of prescriptions. Referral clinics prescribed less analgesics than that provided in the EC. There were mostly no significant differences in prescription habits by patients’ age group, gender and triage code.ConclusionPresenting complaints in our study were varied and likely to result in mild to moderate pain. Only a minority of patients received analgesics at initial contact. Standardised protocols providing treatment guidance for nurse-initiated pain management at initial contact is thus important. There were no significant differences in analgesics prescribed for adults and the elderly, which is worrisome given the potential negative side effects of analgesics in the elderly. Similar concerns in our paediatric population were not noted. Ensuring adequate analgesia with cognisance for safety at the extremes of age is of paramount importance.
Highlights
Emergency Centres (ECs) in African regions such as KwaZulu-Natal (KZN) face many challenges, including the high burden of trauma cases that are seen on a daily basis
All healthcare professional (HCP) working in the EC were asked to complete data collection sheets voluntarily and anonymously in the form of a survey with a closed-ended questionnaire for patients that they treated during their shift that had presented with minor trauma, over the study period
Given that tissue injury results in release of inflammatory mediators that often result in pain, the minor trauma presentations noted in our study are likely to have resulted in mild to moderate pain
Summary
Emergency Centres (ECs) in African regions such as KwaZulu-Natal (KZN) face many challenges, including the high burden of trauma cases that are seen on a daily basis. Trauma-related injuries contribute around 25% of the workload in most state hospital ECs in KZN.[3] Pain, initiated by inflammatory mediators, accompanies most tissue injury. Emergency Centres (ECs) have a prominent trauma burden requiring effective pain management. This study aimed to review analgesia-prescribing habits in minor trauma, reviewing the patient demographics and diagnoses, analgesia-prescribing habits of health care professionals (HCPs) managing these cases, and differences in prescribing noted by patients’ age group, gender and triage code
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