OBJECTIVES:

Providing timely pain management to trauma patients is important to avoid unnecessary patient suffering METHODS:

A retrospective chart review was conducted to understand pain relief treatments, timelines and outcomes in medical emergency situations across Europe (Belgium, France, Germany, Italy, Spain, and Sweden) and Australia. Ambulance and hospital notes of 856 patients were reviewed by 189 emergency specialists. In Australia where low dose inhaled Methoxyflurane is available for emergency relief of moderate to severe pain in conscious adult patients with trauma and associated pain, a sub-sample of 85 patients receiving low dose Methoxyflurane was compared to non- Methoxyflurane patients using propensity score matching.

RESULTS:

The mean (SD) time to first pain relieve treatment after paramedic arrival was 35.6 (35.09) minutes. It was significantly longer for total EU (38.1 [34.65]) compared to Australia ( 29.9 [35.48]) minutes (p=0.0017). Nonetheless, there was considerable variation in time range for the EU 0-339 minutes, as well as Australia 0-189 minutes. The mean (SD) time from paramedic / emergency assistance to first pain relief treatment in the Australia sub-sample treated with low dose Methoxyflurane group was 21.7 minutes (24.24) vs. 39.1 minutes (42.95) in the non-Methoxyflurane group (p-value 0.0013).

CONCLUSIONS:

There appears to be unmet need for fast pain relief in pre-hospital care in Europe. Further observational research is warranted to monitor how the introduction of low dose Methoxyflurane as a pain relief option in paramedic care in Europe could lead to faster pain relief in emergency care.