nalbuphine and Fractures--Bone

The use of intravenous nalbuphine in pre-hospital settings by paramedics has been demonstrated to be safe and effective. We assessed the effect of this additional intervention by comparing the time spent on-scene by ambulance crews treating patients with fractures of the tibia and fibula who received intravenous nalbuphine with those who had placement of an intravenous cannula alone and those who had neither cannula nor nalbuphine. The mean on-scene times were 17.1 min without cannulation, 29.9 min for cannulation without nalbuphine and 37.5 min for cannulation and administration of nalbuphine. The benefits of effective pre-hospital analgesia thus have a cost in terms of time. Continued audit of interventions and on-scene times is important to prevent inappropriate delays in pre-hospital care which may cause clinical and operational problems.

Topics: Adolescent; Adult; Analgesia; Emergency Medical Services; Emergency Medical Technicians; England; Female; Fibula; Fractures, Bone; Humans; Infusions, Intravenous; Male; Nalbuphine; Tibial Fractures; Time and Motion Studies

One-hundred sixteen patients were given nalbuphine by 10 specifically trained ambulance paramedics over a 9-month period. Forty-seven had suspected myocardial infarction and 69 had sustained trauma or burns. The mean pain score measured by a 10-cm visual analogue scale fell from 8 before analgesia to 3. This was highly significant. There were no serious side effects. We conclude that nalbuphine can be safely administered by trained paramedics to provide effective analgesia to those in pain in a prehospital setting.

Topics: Allied Health Personnel; Analgesia; Burns; Emergency Medical Services; Fractures, Bone; Humans; Injections, Intravenous; Middle Aged; Myocardial Infarction; Nalbuphine; Pain Measurement