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Research Article

The Implementation and Evaluation of an Evidence-based Statewide Prehospital Pain Management Protocol Developed using the National Prehospital Evidence-based Guideline Model Process for Emergency Medical Services

Kathleen M. Brownfrom the Department of Pediatrics and Emergency Medicine, George Washington School of Medicine, Washington, DC (KMB); Emergency Department, Children's National Medical Center, Washington, DC (KMB); Maryland Institute for Emergency Medical Services Systems, Baltimore, Maryland (RA); Health Resources and Services Administration/Maternal and Child Health Bureau, Rockville, Maryland (TSW); Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland (BL); Baltimore City Fire Department, Baltimore Maryland (BL); Shock Trauma and Anesthesiology Research–Organized Research Center, University of Maryland School of Medicine, Baltimore Maryland (SH); Department of Pediatrics, Emergency Medicine, and Health Policy, George Washington University School of Medicine and Public Health, Washington, DC (JLW); Child Health Advocacy Institute, Children's National Medical Center, Washington, DC (JLW); and Department of Emergency Medicine, Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland (JMH).Correspondence[email protected]

, MD,

Jon Mark Hirshonfrom the Department of Pediatrics and Emergency Medicine, George Washington School of Medicine, Washington, DC (KMB); Emergency Department, Children's National Medical Center, Washington, DC (KMB); Maryland Institute for Emergency Medical Services Systems, Baltimore, Maryland (RA); Health Resources and Services Administration/Maternal and Child Health Bureau, Rockville, Maryland (TSW); Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland (BL); Baltimore City Fire Department, Baltimore Maryland (BL); Shock Trauma and Anesthesiology Research–Organized Research Center, University of Maryland School of Medicine, Baltimore Maryland (SH); Department of Pediatrics, Emergency Medicine, and Health Policy, George Washington University School of Medicine and Public Health, Washington, DC (JLW); Child Health Advocacy Institute, Children's National Medical Center, Washington, DC (JLW); and Department of Emergency Medicine, Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland (JMH).

, MD, MPH, PhD,

Richard Alcortafrom the Department of Pediatrics and Emergency Medicine, George Washington School of Medicine, Washington, DC (KMB); Emergency Department, Children's National Medical Center, Washington, DC (KMB); Maryland Institute for Emergency Medical Services Systems, Baltimore, Maryland (RA); Health Resources and Services Administration/Maternal and Child Health Bureau, Rockville, Maryland (TSW); Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland (BL); Baltimore City Fire Department, Baltimore Maryland (BL); Shock Trauma and Anesthesiology Research–Organized Research Center, University of Maryland School of Medicine, Baltimore Maryland (SH); Department of Pediatrics, Emergency Medicine, and Health Policy, George Washington University School of Medicine and Public Health, Washington, DC (JLW); Child Health Advocacy Institute, Children's National Medical Center, Washington, DC (JLW); and Department of Emergency Medicine, Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland (JMH).

, MD,

Tasmeen S. Weikfrom the Department of Pediatrics and Emergency Medicine, George Washington School of Medicine, Washington, DC (KMB); Emergency Department, Children's National Medical Center, Washington, DC (KMB); Maryland Institute for Emergency Medical Services Systems, Baltimore, Maryland (RA); Health Resources and Services Administration/Maternal and Child Health Bureau, Rockville, Maryland (TSW); Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland (BL); Baltimore City Fire Department, Baltimore Maryland (BL); Shock Trauma and Anesthesiology Research–Organized Research Center, University of Maryland School of Medicine, Baltimore Maryland (SH); Department of Pediatrics, Emergency Medicine, and Health Policy, George Washington University School of Medicine and Public Health, Washington, DC (JLW); Child Health Advocacy Institute, Children's National Medical Center, Washington, DC (JLW); and Department of Emergency Medicine, Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland (JMH).

, DrPh, MPH,

Ben Lawnerfrom the Department of Pediatrics and Emergency Medicine, George Washington School of Medicine, Washington, DC (KMB); Emergency Department, Children's National Medical Center, Washington, DC (KMB); Maryland Institute for Emergency Medical Services Systems, Baltimore, Maryland (RA); Health Resources and Services Administration/Maternal and Child Health Bureau, Rockville, Maryland (TSW); Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland (BL); Baltimore City Fire Department, Baltimore Maryland (BL); Shock Trauma and Anesthesiology Research–Organized Research Center, University of Maryland School of Medicine, Baltimore Maryland (SH); Department of Pediatrics, Emergency Medicine, and Health Policy, George Washington University School of Medicine and Public Health, Washington, DC (JLW); Child Health Advocacy Institute, Children's National Medical Center, Washington, DC (JLW); and Department of Emergency Medicine, Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland (JMH).

, DO, EMT-P,

Shiu Hofrom the Department of Pediatrics and Emergency Medicine, George Washington School of Medicine, Washington, DC (KMB); Emergency Department, Children's National Medical Center, Washington, DC (KMB); Maryland Institute for Emergency Medical Services Systems, Baltimore, Maryland (RA); Health Resources and Services Administration/Maternal and Child Health Bureau, Rockville, Maryland (TSW); Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland (BL); Baltimore City Fire Department, Baltimore Maryland (BL); Shock Trauma and Anesthesiology Research–Organized Research Center, University of Maryland School of Medicine, Baltimore Maryland (SH); Department of Pediatrics, Emergency Medicine, and Health Policy, George Washington University School of Medicine and Public Health, Washington, DC (JLW); Child Health Advocacy Institute, Children's National Medical Center, Washington, DC (JLW); and Department of Emergency Medicine, Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland (JMH).

, MS &

Joseph L. Wrightfrom the Department of Pediatrics and Emergency Medicine, George Washington School of Medicine, Washington, DC (KMB); Emergency Department, Children's National Medical Center, Washington, DC (KMB); Maryland Institute for Emergency Medical Services Systems, Baltimore, Maryland (RA); Health Resources and Services Administration/Maternal and Child Health Bureau, Rockville, Maryland (TSW); Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland (BL); Baltimore City Fire Department, Baltimore Maryland (BL); Shock Trauma and Anesthesiology Research–Organized Research Center, University of Maryland School of Medicine, Baltimore Maryland (SH); Department of Pediatrics, Emergency Medicine, and Health Policy, George Washington University School of Medicine and Public Health, Washington, DC (JLW); Child Health Advocacy Institute, Children's National Medical Center, Washington, DC (JLW); and Department of Emergency Medicine, Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland (JMH).

, MD, MPH show all

Figures & data

Table 1. All trauma/burn EMS transports by study period for reporting jurisdictions in Maryland, July 2010 to June 2012 (N = 3,491)

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Table 2. Demographic variables for ALS trauma/burn transports by study period for reporting jurisdictions in Maryland, July 2010 to June 2012 (N = 2,128)

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Table 3. Frequency of morphine administration among ALS trauma/burn EMS transports by study period for reporting jurisdictions in Maryland, July 2010 to June 2012

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Table 4. Percentage of eligible transports receiving morphine by documented pain score category in the pre- and postintervention period

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Table 5a. Total dose of morphine (mg/patient transported among ALS trauma/burn transports by study period for reporting jurisdictions in Maryland, July 2010 to June 2012 (N = 1,508)

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Table 5b. Amount of morphine administered (mg/kg) among ALS trauma/burn EMS transports by study period for reporting jurisdiction in Maryland, July 2010 to June 2012 (N = 1,508)

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The Implementation and Evaluation of an Evidence-based Statewide Prehospital Pain Management Protocol Developed using the National Prehospital Evidence-based Guideline Model Process for Emergency Medical Services

Table 1. All trauma/burn EMS transports by study period for reporting jurisdictions in Maryland, July 2010 to June 2012 (N = 3,491)

Table 2. Demographic variables for ALS trauma/burn transports by study period for reporting jurisdictions in Maryland, July 2010 to June 2012 (N = 2,128)

Table 3. Frequency of morphine administration among ALS trauma/burn EMS transports by study period for reporting jurisdictions in Maryland, July 2010 to June 2012

Table 4. Percentage of eligible transports receiving morphine by documented pain score category in the pre- and postintervention period

Table 5a. Total dose of morphine (mg/patient transported among ALS trauma/burn transports by study period for reporting jurisdictions in Maryland, July 2010 to June 2012 (N = 1,508)

Table 5b. Amount of morphine administered (mg/kg) among ALS trauma/burn EMS transports by study period for reporting jurisdiction in Maryland, July 2010 to June 2012 (N = 1,508)

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The Implementation and Evaluation of an Evidence-based Statewide Prehospital Pain Management Protocol Developed using the National Prehospital Evidence-based Guideline Model Process for Emergency Medical Services

Figures & data

Table 1. All trauma/burn EMS transports by study period for reporting jurisdictions in Maryland, July 2010 to June 2012 (N = 3,491)

Table 2. Demographic variables for ALS trauma/burn transports by study period for reporting jurisdictions in Maryland, July 2010 to June 2012 (N = 2,128)

Table 3. Frequency of morphine administration among ALS trauma/burn EMS transports by study period for reporting jurisdictions in Maryland, July 2010 to June 2012

Table 4. Percentage of eligible transports receiving morphine by documented pain score category in the pre- and postintervention period

Table 5a. Total dose of morphine (mg/patient transported among ALS trauma/burn transports by study period for reporting jurisdictions in Maryland, July 2010 to June 2012 (N = 1,508)

Table 5b. Amount of morphine administered (mg/kg) among ALS trauma/burn EMS transports by study period for reporting jurisdiction in Maryland, July 2010 to June 2012 (N = 1,508)

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