创伤急救医护人员处理背痛：范围综述。

Paramedic management of back pain: a scoping review.

机构信息

Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, NSW, Australia.

Sydney Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.

出版信息

BMC Emerg Med. 2022 Aug 9;22(1):144. doi: 10.1186/s12873-022-00699-1.

DOI:10.1186/s12873-022-00699-1

PMID:35945506

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9361588/

Abstract

BACKGROUND

Research examining paramedic care of back pain is limited.

OBJECTIVE

To describe ambulance service use and usual paramedic care for back pain, the effectiveness and safety of paramedic care of back pain, and the characteristics of people with back pain who seek care from paramedics.

METHODS

We included published peer-reviewed studies of people with back pain who received any type of paramedic care on-scene and/or during transport to hospital. We searched MEDLINE, EMBASE, CINAHL, Web of Science and SciELO from inception to July 2022. Two authors independently screened and selected the studies, performed data extraction, and assessed the methodological quality using the PEDro, AMSTAR 2 and Hawker tools. This review followed the JBI methodological guidance for scoping reviews and PRISMA extension for scoping reviews.

RESULTS

From 1987 articles we included 26 articles (25 unique studies) consisting of 22 observational studies, three randomised controlled trials and one review. Back pain is frequently in the top 3 reasons for calls to an ambulance service with more than two thirds of cases receiving ambulance dispatch. It takes ~ 8 min from time of call to an ambulance being dispatched and 16% of calls for back pain receive transport to hospital. Pharmacological management of back pain includes benzodiazepines, NSAIDs, opioids, nitrous oxide, and paracetamol. Non-pharmacological care is poorly reported and includes referral to alternate health service, counselling and behavioural interventions and self-care advice. Only three trials have evaluated effectiveness of paramedic treatments (TENS, active warming, and administration of opioids) and no studies provided safety or costing data.

CONCLUSION

Paramedics are frequently responding to people with back pain. Use of pain medicines is common but varies according to the type of back pain and setting, while non-pharmacological care is poorly reported. There is a lack of research evaluating the effectiveness and safety of paramedic care for back pain.

摘要

背景

针对急救人员处理背痛的研究有限。

目的

描述急救服务的使用情况和急救人员对背痛的常规护理，评估急救人员处理背痛的效果和安全性，以及向急救人员寻求背痛治疗的人群特征。

方法

我们纳入了在现场和/或在送往医院的途中接受任何类型急救人员护理的背痛患者的已发表同行评审研究。我们检索了 MEDLINE、EMBASE、CINAHL、Web of Science 和 SciELO 数据库，检索时间从建库至 2022 年 7 月。两名作者独立筛选和选择研究、提取数据，并使用 PEDro、AMSTAR 2 和 Hawker 工具评估方法学质量。本综述遵循 JBI 范围综述方法学指南和扩展的 PRISMA 范围综述清单。

结果

从 1987 篇文章中，我们纳入了 26 篇文章（25 项独立研究），包括 22 项观察性研究、3 项随机对照试验和 1 项综述。背痛是呼叫急救服务的前 3 大常见原因之一，超过三分之二的病例会派救护车。从呼叫到救护车出动的时间约为 8 分钟，16%的背痛呼叫会被送往医院。背痛的药物治疗包括苯二氮䓬类、非甾体抗炎药、阿片类药物、一氧化二氮和对乙酰氨基酚。非药物治疗的报道很少，包括转介到其他卫生服务、咨询和行为干预以及自我护理建议。只有三项试验评估了急救人员治疗（经皮电神经刺激、主动加热和阿片类药物给药）的效果，没有研究提供安全性或成本数据。