Fentanyl trauma analgesia use in air medical scene transports

Abstract 

This study assessed frequency, safety and efficacy of prehospital fentanyl analgesia during 6 months’ adult and pediatric helicopter trauma scene transports (213 doses in 177 patients). We reviewed flight records for pain assessment and analgesia provision, effect, and complications. Analgesia was administered to 46/49 (93.9%) intubated patients. In non-intubated patients, pain assessment was documented in 112 of 128 (87.5%), and analgesia was offered, or there was no pain, in 97/128 (75.8%). Of the 67 non-intubated patients to whom analgesia was administered, post-analgesia pain assessment was documented in 62 (92.5%) and pain improved in 53 (79.1% of 67). Post-analgesia blood pressure dropped below 90 torr in 2/177 cases (1.1%, 95% confidence interval [CI] 0.1–4.0%). Post-analgesia S_pO₂ did not drop below 90% in any patients (95% CI 0–2.3%). In this study, prehospital providers performed well with respect to pain assessment and treatment. Fentanyl was provided frequently, with good effect and minimal cardiorespiratory consequence.

Keywords:  fentanyl , prehospital , analgesia , helicopter , air medical transport