Ambulance clinician perspectives of disparity in prehospital child pain management: A mixed methods study
Abstract Background When children suffer acute pain, the ambulance service is often involved to provide initial assessment, treatment, and transport. Several predictors of effective pain management have been identified, including children who are younger (0‐5 years), administered analgesics, and liv...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-06-01
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| Series: | Health Science Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/hsr2.261 |
| _version_ | 1818644037461082112 |
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| author | Gregory Adam Whitley Pippa Hemingway Graham Richard Law Aloysius Niroshan Siriwardena |
| author_facet | Gregory Adam Whitley Pippa Hemingway Graham Richard Law Aloysius Niroshan Siriwardena |
| author_sort | Gregory Adam Whitley |
| collection | DOAJ |
| description | Abstract Background When children suffer acute pain, the ambulance service is often involved to provide initial assessment, treatment, and transport. Several predictors of effective pain management have been identified, including children who are younger (0‐5 years), administered analgesics, and living in homes from more affluent areas. Objective To explain previously identified predictors of effective prehospital pain management in children. Design Mixed methods sequential explanatory study. Setting and participants East Midlands Ambulance Service National Health Service Trust paramedics and emergency medical technicians (EMTs) participated in face‐to‐face semi‐structured interviews. These were audio recorded, transcribed verbatim, and coded using thematic analysis. Meta‐inferences were generated and illustrated within a joint display. Results Twelve clinicians (9 paramedics and 3 EMTs) were interviewed. Median (interquartile range) age was 43.5 years (41.5, 45.75), 58% were male (n = 7) and 58% were parents (n = 7). Possible explanations were provided for all predictors. Younger children were perceived to express more emotion, were easier to distract, and lived more in the moment than their older counterparts, which explained why younger children were more likely to achieve effective pain management. Analgesics were perceived to have a psychosocial benefit in addition to the pharmacological action. Ambulance clinicians felt that children living in more affluent areas were more likely to achieve effective pain management because the kempt environment facilitated assessment and management and clinicians spent more time on scene; this allowed more time for analgesics to take effect. Participants perceived paramedics to be more confident, and it was found that paramedics were older, more experienced, had a greater scope of practice, and spent more time on scene than EMTs. Conclusion Prehospital pain management in children could be improved by facilitating and prioritizing analgesic administration and by ambulance services ensuring a paramedic, or highly trained clinician, is present on each vehicle, necessitating long‐term commitment to staff development. |
| first_indexed | 2024-12-17T00:08:29Z |
| format | Article |
| id | doaj.art-fe5968700f404bcba07b0137b204a261 |
| institution | Directory Open Access Journal |
| issn | 2398-8835 |
| language | English |
| last_indexed | 2024-12-17T00:08:29Z |
| publishDate | 2021-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Health Science Reports |
| spelling | doaj.art-fe5968700f404bcba07b0137b204a2612022-12-21T22:10:54ZengWileyHealth Science Reports2398-88352021-06-0142n/an/a10.1002/hsr2.261Ambulance clinician perspectives of disparity in prehospital child pain management: A mixed methods studyGregory Adam Whitley0Pippa Hemingway1Graham Richard Law2Aloysius Niroshan Siriwardena3Community and Health Research Unit, School of Health and Social Care University of Lincoln Lincoln UKFaculty of Medicine and Health Sciences University of Nottingham Nottingham UKCommunity and Health Research Unit, School of Health and Social Care University of Lincoln Lincoln UKCommunity and Health Research Unit, School of Health and Social Care University of Lincoln Lincoln UKAbstract Background When children suffer acute pain, the ambulance service is often involved to provide initial assessment, treatment, and transport. Several predictors of effective pain management have been identified, including children who are younger (0‐5 years), administered analgesics, and living in homes from more affluent areas. Objective To explain previously identified predictors of effective prehospital pain management in children. Design Mixed methods sequential explanatory study. Setting and participants East Midlands Ambulance Service National Health Service Trust paramedics and emergency medical technicians (EMTs) participated in face‐to‐face semi‐structured interviews. These were audio recorded, transcribed verbatim, and coded using thematic analysis. Meta‐inferences were generated and illustrated within a joint display. Results Twelve clinicians (9 paramedics and 3 EMTs) were interviewed. Median (interquartile range) age was 43.5 years (41.5, 45.75), 58% were male (n = 7) and 58% were parents (n = 7). Possible explanations were provided for all predictors. Younger children were perceived to express more emotion, were easier to distract, and lived more in the moment than their older counterparts, which explained why younger children were more likely to achieve effective pain management. Analgesics were perceived to have a psychosocial benefit in addition to the pharmacological action. Ambulance clinicians felt that children living in more affluent areas were more likely to achieve effective pain management because the kempt environment facilitated assessment and management and clinicians spent more time on scene; this allowed more time for analgesics to take effect. Participants perceived paramedics to be more confident, and it was found that paramedics were older, more experienced, had a greater scope of practice, and spent more time on scene than EMTs. Conclusion Prehospital pain management in children could be improved by facilitating and prioritizing analgesic administration and by ambulance services ensuring a paramedic, or highly trained clinician, is present on each vehicle, necessitating long‐term commitment to staff development.https://doi.org/10.1002/hsr2.261childdeprivationemergency medical servicesemergency medical techniciansmixed methodspain |
| spellingShingle | Gregory Adam Whitley Pippa Hemingway Graham Richard Law Aloysius Niroshan Siriwardena Ambulance clinician perspectives of disparity in prehospital child pain management: A mixed methods study Health Science Reports child deprivation emergency medical services emergency medical technicians mixed methods pain |
| title | Ambulance clinician perspectives of disparity in prehospital child pain management: A mixed methods study |
| title_full | Ambulance clinician perspectives of disparity in prehospital child pain management: A mixed methods study |
| title_fullStr | Ambulance clinician perspectives of disparity in prehospital child pain management: A mixed methods study |
| title_full_unstemmed | Ambulance clinician perspectives of disparity in prehospital child pain management: A mixed methods study |
| title_short | Ambulance clinician perspectives of disparity in prehospital child pain management: A mixed methods study |
| title_sort | ambulance clinician perspectives of disparity in prehospital child pain management a mixed methods study |
| topic | child deprivation emergency medical services emergency medical technicians mixed methods pain |
| url | https://doi.org/10.1002/hsr2.261 |
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