Clinical trial NCT05791253: Pain Management in Primary Intervention of the Mobile Emergency and Resuscitation Service
Official title: Pain Management in Adults in Primary Intervention of the Mobile Emergency and Resuscitation Service of Pontoise
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Pain
Keywords: Pain management
Emergency care
Mobile Emergency and Resuscitation Service
Lead sponsor: Hôpital NOVO
Sponsor class: OTHER
First posted: 2023-03-30
Enrollment: 365
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients who received an intervention from the Mobile Emergency and Resuscitation Service (primary intervention) between 01/11 and 30/11/2021, between 01/03 and 31/03/2022 or between 01/08 and 31/08/2022.

Brief summary: The aim of the study is to carry out an inventory of practices relating to the management of pain: its recognition, assessment and treatment.

Detailed description: Pain is one of the most frequent reasons for seeking emergency care, with a prevalence of approximately 42% in pre-hospital care.

Pain management practices are defined by the French Society of Anaesthesia and Intensive Care (SFAR) and the French Society of Emergency Medicine (SFMU).

Pain must be systematically managed and treated. To do this, it is necessary to start by assessing the pain using self-assessment scales, the VAS (Visual Analogue Pain Scale) or the EN (Numerical Pain Scale) being the two validated scales.

Depending on the intensity of the pain, appropriate treatments should be prescribed:

* If EN \< 6: level I or II analgesic
* If EN \> 6: morphine titration Finally, after the treatment has been implemented, the pain must be re-evaluated using the same self-assessment scales in order to attest to the effectiveness of the treatment.

There is a lack of knowledge of the recommendations for pain management and assessment: 49% of SMUR doctors do not know the SFAR recommendations and only 17% define severe acute pain by a VAS or ENS greater than 6/10.

The aim of the study is to carry out an inventory of practices relating to the management of pain: its recognition, assessment and treatment and to check whether pain management was carried out according to the recommendations of the French Society of Anaesthesia and Intensive Care (SFAR) and the French Society of Emergency Medicine (SFMU).

Eligibility criteria: Inclusion Criteria :

* Patients over 18 years of age,
* Patient managed on primary intervention file between 01/11 and 30/11/2021, between 01/03 and 31/03/2022 or between 01/08 and 31/08/2022,
* Patient transferred to NOVO hospital (Pontoise, Beaumont-sur-Oise or Magny en Vexin site) for further medical care.

Exclusion Criteria :

* Patient in Cardiorespiratory Arrest (CRA),
* Patient in coma,
* Patient without applicant,
* Patient who has expressed his opposition to the collect of his data.

Primary outcomes:
measure: Evaluation of pain management according to the recommendations of the SFAR and SFMU
timeFrame: At the end of the study, an average of one month
Secondary outcomes:
Other outcomes:
Locations:
city: Pontoise
country: France
facility: Mobile Emergency and Resuscitation Unit - NOVO Hospital - Pontoise Site
Study officials:
affiliation: Hospital NOVO - Pontoise site
name: Olivier Fancelli
role: PRINCIPAL_INVESTIGATOR
References:
citation: Vivien B, Adnet F, Bounes V, Cheron G, Combes X, David JS, Diependaele JF, Eledjam JJ, Eon B, Fontaine JP, Freysz M, Michelet P, Orliaguet G, Puidupin A, Ricard-Hibon A, Riou B, Wiel E, de La Coussaye JE. [Sedation and analgesia in emergency structure. Reactualization 2010 of the Conference of Experts of Sfar of 1999]. Ann Fr Anesth Reanim. 2012 Apr;31(4):391-404. doi: 10.1016/j.annfar.2012.02.006. Epub 2012 Mar 28. No abstract available. French.
citation: Galinski M, Ruscev M, Gonzalez G, Kavas J, Ameur L, Biens D, Lapostolle F, Adnet F. Prevalence and management of acute pain in prehospital emergency medicine. Prehosp Emerg Care. 2010 Jul-Sep;14(3):334-9. doi: 10.3109/10903121003760218.
citation: Albrecht E, Taffe P, Yersin B, Schoettker P, Decosterd I, Hugli O. Undertreatment of acute pain (oligoanalgesia) and medical practice variation in prehospital analgesia of adult trauma patients: a 10 yr retrospective study. Br J Anaesth. 2013 Jan;110(1):96-106. doi: 10.1093/bja/aes355. Epub 2012 Oct 11.
citation: Ricard-Hibon A, Chollet C, Saada S, Loridant B, Marty J. A quality control program for acute pain management in out-of-hospital critical care medicine. Ann Emerg Med. 1999 Dec;34(6):738-44. doi: 10.1016/s0196-0644(99)70099-5.