Pain Management in Primary Intervention of the Mobile Emergency and Resuscitation Service (DOLSMUR)

Pain Management in Adults in Primary Intervention of the Mobile Emergency and Resuscitation Service of Pontoise

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

Study Overview

• Status: Completed
• Conditions: Pain
• Intervention / Treatment: Other: Pain management

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).

• Study Type: Observational
• Enrollment (Actual): 365

Contacts and Locations

Study Locations

• France
  • Pontoise, France, 95300
    • Mobile Emergency and Resuscitation Unit - NOVO Hospital - Pontoise Site

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• 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.

Description

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.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Evaluation of pain management according to the recommendations of the SFAR and SFMU	The the recommendations of the SFAR and SFMU about Pain management is based on a composite criterion with the following items: Pain recognition and assessment EN (Numerical scale); Implementation of an adapted therapy (prescriptions) according to the pain scale scores; Re-evaluation of pain EN (Numerical scale) The evaluation of the objective is based on this composite criterion : for each item, the answer will be Yes or No. The outcom is validate if the answer of each item is yes.	At the end of the study, an average of one month

Collaborators and Investigators

• Sponsor: Centre Hospitalier René Dubos
• Investigators: Principal Investigator: Olivier Fancelli, Hospital NOVO - Pontoise site

Publications and helpful links

General Publications

• 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.
• 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.
• 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.
• 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.

Study record dates

Study Major Dates

• Study Start (Actual): March 9, 2023
• Primary Completion (Actual): March 23, 2023
• Study Completion (Actual): March 23, 2023

Study Registration Dates

• First Submitted: March 14, 2023
• First Submitted That Met QC Criteria: March 28, 2023
• First Posted (Actual): March 30, 2023

Study Record Updates

• Last Update Posted (Actual): May 26, 2023
• Last Update Submitted That Met QC Criteria: May 25, 2023
• Last Verified: May 1, 2023

More Information

Terms related to this study

• Keywords: Pain management; Emergency care; Mobile Emergency and Resuscitation Service
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Emergencies
• Other Study ID Numbers: CHRD 1322

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No