The use of strong analgesics for prehospital pain management in children in the region of Southern Denmark: a register-based study
Abstract Background Acute pain in the prehospital setting is frequent and prehospital pain management presents multiple challenges, especially in children. There is a lack of high-level evidence regarding prehospital pain management in the paediatric population worldwide. In Denmark, this lack of ev...
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BMC
2025-02-01
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| Series: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
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| Online Access: | https://doi.org/10.1186/s13049-025-01339-w |
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| author | Josefine Tvede Colding-Jørgensen Gina Maj Graven Brandstrup Vibe Maria Laden Nielsen Josefine Gradman Line Anker Bang Thybo Peter Martin Hansen Daniel Wittrock Stig Nikolaj Fasmer Blomberg Helle Collatz Christensen Søren Mikkelsen |
| author_facet | Josefine Tvede Colding-Jørgensen Gina Maj Graven Brandstrup Vibe Maria Laden Nielsen Josefine Gradman Line Anker Bang Thybo Peter Martin Hansen Daniel Wittrock Stig Nikolaj Fasmer Blomberg Helle Collatz Christensen Søren Mikkelsen |
| author_sort | Josefine Tvede Colding-Jørgensen |
| collection | DOAJ |
| description | Abstract Background Acute pain in the prehospital setting is frequent and prehospital pain management presents multiple challenges, especially in children. There is a lack of high-level evidence regarding prehospital pain management in the paediatric population worldwide. In Denmark, this lack of evidence particularly concerns the frequency of the prehospital use of strong analgesics. Guidelines are sparse but there is evidence that prehospital fentanyl may be administered up to 5 µg/kg. Method This register-based study investigated the prehospital analgesic treatment in the population under 15 years from January 2017 to December 2022 in the Region of Southern Denmark. Data were extracted from electronic prehospital medical records. The analgesic treatment was characterised by the type of medication, dosage, administration method, and cause of ambulance dispatch. Lastly, response- and transport times were registered. Results A total of 28,933 prehospital paediatric medical records were examined. In one in seventeen of all prehospital contacts with children, fentanyl, alfentanil, morphine and/or s-ketamine was administered. Three-quarters of the doses of strong analgesics were administered to patients older than 10 years. Fentanyl was the most frequently administered medication (96.4%). The median fentanyl-equipotent doses of opioids were 1.7 µg/kg adjusted according to standardised patient weight. In 63.4% of cases, the analgesic treatment was administered intravenously. Conclusion The doses of opioids as administered by the EMS personnel seem safe as 97% of the doses were within the recommended range and even at the lower end of the recommended range. Although apparently safe, the utilisation of strong analgesics points to a risk of under-treating pain in children. |
| format | Article |
| id | doaj-art-d7ba05c5803b4d72a640b8e14f4c97aa |
| institution | Kabale University |
| issn | 1757-7241 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| spelling | doaj-art-d7ba05c5803b4d72a640b8e14f4c97aa2025-02-09T12:52:11ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412025-02-013311910.1186/s13049-025-01339-wThe use of strong analgesics for prehospital pain management in children in the region of Southern Denmark: a register-based studyJosefine Tvede Colding-Jørgensen0Gina Maj Graven Brandstrup1Vibe Maria Laden Nielsen2Josefine Gradman3Line Anker Bang Thybo4Peter Martin Hansen5Daniel Wittrock6Stig Nikolaj Fasmer Blomberg7Helle Collatz Christensen8Søren Mikkelsen9The Prehospital Research Unit, Region of Southern Denmark, Odense University HospitalThe Prehospital Research Unit, Region of Southern Denmark, Odense University HospitalCentre for Prehospital and Emergency Research, Aalborg University and Aalborg University HospitalHans Christian Andersen Children’s Hospital, Odense University HospitalHans Christian Andersen Children’s Hospital, Odense University HospitalThe Prehospital Research Unit, Region of Southern Denmark, Odense University HospitalThe Prehospital Research Unit, Region of Southern Denmark, Odense University HospitalPrehospital Center, Region ZealandPrehospital Center, Region ZealandThe Prehospital Research Unit, Region of Southern Denmark, Odense University HospitalAbstract Background Acute pain in the prehospital setting is frequent and prehospital pain management presents multiple challenges, especially in children. There is a lack of high-level evidence regarding prehospital pain management in the paediatric population worldwide. In Denmark, this lack of evidence particularly concerns the frequency of the prehospital use of strong analgesics. Guidelines are sparse but there is evidence that prehospital fentanyl may be administered up to 5 µg/kg. Method This register-based study investigated the prehospital analgesic treatment in the population under 15 years from January 2017 to December 2022 in the Region of Southern Denmark. Data were extracted from electronic prehospital medical records. The analgesic treatment was characterised by the type of medication, dosage, administration method, and cause of ambulance dispatch. Lastly, response- and transport times were registered. Results A total of 28,933 prehospital paediatric medical records were examined. In one in seventeen of all prehospital contacts with children, fentanyl, alfentanil, morphine and/or s-ketamine was administered. Three-quarters of the doses of strong analgesics were administered to patients older than 10 years. Fentanyl was the most frequently administered medication (96.4%). The median fentanyl-equipotent doses of opioids were 1.7 µg/kg adjusted according to standardised patient weight. In 63.4% of cases, the analgesic treatment was administered intravenously. Conclusion The doses of opioids as administered by the EMS personnel seem safe as 97% of the doses were within the recommended range and even at the lower end of the recommended range. Although apparently safe, the utilisation of strong analgesics points to a risk of under-treating pain in children.https://doi.org/10.1186/s13049-025-01339-wPrehospital analgesiaPrehospital paediatric patientsPrehospital opioids |
| spellingShingle | Josefine Tvede Colding-Jørgensen Gina Maj Graven Brandstrup Vibe Maria Laden Nielsen Josefine Gradman Line Anker Bang Thybo Peter Martin Hansen Daniel Wittrock Stig Nikolaj Fasmer Blomberg Helle Collatz Christensen Søren Mikkelsen The use of strong analgesics for prehospital pain management in children in the region of Southern Denmark: a register-based study Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Prehospital analgesia Prehospital paediatric patients Prehospital opioids |
| title | The use of strong analgesics for prehospital pain management in children in the region of Southern Denmark: a register-based study |
| title_full | The use of strong analgesics for prehospital pain management in children in the region of Southern Denmark: a register-based study |
| title_fullStr | The use of strong analgesics for prehospital pain management in children in the region of Southern Denmark: a register-based study |
| title_full_unstemmed | The use of strong analgesics for prehospital pain management in children in the region of Southern Denmark: a register-based study |
| title_short | The use of strong analgesics for prehospital pain management in children in the region of Southern Denmark: a register-based study |
| title_sort | use of strong analgesics for prehospital pain management in children in the region of southern denmark a register based study |
| topic | Prehospital analgesia Prehospital paediatric patients Prehospital opioids |
| url | https://doi.org/10.1186/s13049-025-01339-w |
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