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The intensity of pain in the prehospital setting is most strongly reflected in the respiratory rate among physiological parameters.
Ambulance Service, Skaraborg Hospital.
Research and Development Centre, Skaraborg Hospital.
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.ORCID iD: 0000-0003-4139-6235
Department of Medicine, Skövde County Hospital.
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2019 (English)In: American Journal of Emergency Medicine, ISSN 0735-6757, E-ISSN 1532-8171, Vol. 37, no 12, p. 2125-2131, article id S0735-6757(19)30038-5Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: In order to treat pain optimally, the Emergency Medical Service (EMS) clinician needs to be able to make a reasonable estimation of the severity of the pain. It is hypothesised that various physiological parameters will change as a response to pain.

AIM: In a cohort of patients who were seen by EMS clinicians, to relate the patients' estimated intensity of pain to various physiological parameters.

METHODS: Patients who called for EMS due to pain in a part of western Sweden were included. The intensity of pain was assessed according to the visual analogue scale (VAS) or the Numerical Rating Scale (NRS). The following were assessed the same time as pain on EMS arrival: heart rate, systolic and diastolic blood pressure, respiratory rate, moist skin and paleness.

RESULTS: In all, 19,908 patients (≥18 years), were studied (51% women). There were significant associations between intensity of pain and the respiratory rate (r = 0.198; p < 0.0001), heart rate (r = 0.037; p < 0.0001), systolic blood pressure (r = -0.029; p < 0.0001), moist skin (r = 0.143; p < 0.0001) and paleness (r = 0.171; p < 0.0001). The strongest association was found with respiratory rate among patients aged 18-64 years (r = 0.258; p < 0.0001).

CONCLUSION: In the prehospital setting, there were significant but weak correlations between intensity of pain and physiological parameters. The most clinically relevant association was found with an increased respiratory rate and presence of pale and moist skin among patients aged < 65 years. Among younger patients, respiratory rate may support in the clinical evaluation of pain.

Place, publisher, year, edition, pages
2019. Vol. 37, no 12, p. 2125-2131, article id S0735-6757(19)30038-5
Keywords [en]
Intensity, Pain, Prehospital setting, Vital parameters
National Category
Anesthesiology and Intensive Care
Research subject
Människan i vården
Identifiers
URN: urn:nbn:se:hb:diva-22176DOI: 10.1016/j.ajem.2019.01.032ISI: 000502581800002PubMedID: 30718118Scopus ID: 2-s2.0-85060890032OAI: oai:DiVA.org:hb-22176DiVA, id: diva2:1376462
Available from: 2019-12-09 Created: 2019-12-09 Last updated: 2020-01-28Bibliographically approved

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Herlitz, JohanAxelsson, Christer

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