Prehospital and En Route Analgesic Use in the Combat Setting: A Prospectively Designed, Multicenter, Observational Study

Abstract

Combat injuries result in acute, severe pain. Early use of analgesia after injury is known to be beneficial. Studies on prehospital analgesia in combat are limited and no prospectively designed study has reported the use of analgesics in the prehospital and en route care setting. Our objective was to describe the current use of prehospital analgesia in the combat setting. This prospectively designed, multicenter, observational, prehospital combat study was undertaken at medical treatment facilities (MTF) in Afghanistan between October 2012 and September 2013. It formed part of a larger study aimed at describing the use of lifesaving interventions in combat. On arrival at the MTF, trained on-site investigators enrolled eligible patients and completed standardized data capture forms, which included the name, dose, and route of administration of all prehospital analgesics, and the type of provider who administered the drug. Physiological data were retrospectively ascribed as soon as practicable. The study was prospectively approved by the Brooke Army Medical Center institutional review board. Data were collected on 228 patients, with 305 analgesia administrations recorded. The predominant mechanism of injury was blast (50%), followed by penetrating (41%), and blunt (9%). The most common analgesic used was ketamine, followed by morphine. A combination of analgesics was given to 29% of patients; the most common combination was ketamine and morphine.

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Document Details

Document Type
Technical Report
Publication Date
Mar 01, 2015
Accession Number
ADA620459

Entities

People

  • Alex Mora
  • Alicia Ervin
  • Ed Barnard
  • John Clifford
  • Lawrence N. Petz
  • Marcie Fowler
  • Stuart Tyner
  • Vikhyat S Bebarta

Organizations

  • United States Army Institute of Surgical Research

Tags

DTIC Thesaurus Topics

  • Air Force
  • Analgesia
  • Cardiovascular Physiological Phenomena
  • Emergencies
  • Emergency Response
  • Fentanyl
  • Health Services
  • Heart Rate
  • Ketamine
  • Medical Evacuation
  • Medical Personnel
  • Military Medicine
  • Opioids
  • Pain Management
  • Therapy
  • Vital Signs
  • Warfare

Fields of Study

  • Medicine

Readers

  • Clinical Trial Research.
  • Neurotrauma and Rehabilitation Medicine.
  • Trauma or Military Medicine