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The Impact of Patient Gender on Paramedic Pain Management in the Out-of-hospital Setting
Abstract   Peer reviewed

The Impact of Patient Gender on Paramedic Pain Management in the Out-of-hospital Setting

Bill Lord, J Cui and A-M Kelly
Academic Emergency Medicine, Vol.14(Supplement 1), p.S114
Annual Meeting of the Society for Academic Emergency Medicine, 2007 (Chicago, United States, 16-May-2007–19-May-2007)
2007
DOI: https://doi.org/10.1197/j.aem.2007.03.704
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https://doi.org/10.1197/j.aem.2007.03.704View
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Abstract

Clinical Sciences Public Health and Health Services
Objectives: This study sought to establish the impact of patient gender on the provision of analgesia by paramedics for patients reporting pain in the out-of-hospital setting. Methods: This project is a sub-study of a larger study investigating the prevalence and treatment of pain by paramedics in Australia. It is a retrospective study of paramedic patient care records and included all adult patients with GCS >12 transported to hospital by ambulance in a major city in Australia for the 7-day period 16-22 August 2005. Data extracted explicitly included demographics, patient report of pain and severity, provision of analgesia by paramedics and type of analgesia provided. Paramedics in this jurisdiction may administer inhaled methoxyflurane or IV morphine according to protocols. The outcomes of interest were gender differences in the provision of analgesia. Data analysis was by descriptive statistics and logistic regression. Results: Of the 3,357 patients transported by paramedics, 1766 (53%) reported pain. 52% were female and mean initial pain score (on a 0-10 verbal numeric pain scale) was 5.5. The proportion of patients reporting pain that did not receive analgesia was 45% (791/1,766). 11% of patients declined analgesia when it was offered. There was no significant gender difference in rate of refusal (p = 0.92). There was no gender difference in patients not receiving paramedic-initiated analgesia (p = 0.93). There were however significant gender differences in the typeof analgesia administered, with males more likely to receive morphine (17%) than females (13%, p = 0.009).This difference remains significant when controlled for type of pain, age and pain severity (OR for females receiving morphine 0.61, 95% CI = 0.44 to 0.84). Conclusions: Gender is not associated with the rate of paramedic-initiated analgesia, but is associated with differences in the type of analgesia administered. A significant proportion of patients reporting pain decline analgesia when it is offered.

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