• Managing moderate and severe pain in mountain rescue

    by Alan Batt. Last modified: 31/03/14

    mountain

    Summary

    • Better training on recognition and management of pain recommended for all involved in mountain rescue.
    • A range of medications should be carried.
    • Opioids recommended as the core drugs for managing moderate or severe pain.

     
    Ellerton J1, Milani M, Blancher M, Zen-Ruffinen G, Skaiaa SC, Brink B, Lohani A, Paal P. Managing moderate and severe pain in mountain rescue. High Alt Med Biol. 2014 Apr;15(1):8-14. PMID: 24673533.

    Abstract

    Aims

    We aimed to describe evidence-based options for prehospital analgesia, and to offer practical advice to physicians and nonphysicians working in mountain rescue.

    Methods

    A literature search was performed; the results and recommendations were discussed among the authors. Four authors considered a scenario. The final article was discussed and approved by the International Commission for Mountain Emergency Medicine (ICAR MEDCOM) in October 2013.

    Results

    Many health care providers fail to recognize, assess, and treat pain adequately. Assessment scales and treatment protocols should be implemented in mountain rescue services to encourage better management of pain. Specific training in assessing and managing pain is essential for all mountain rescuers. Persons administrating analgesics should receive appropriate detailed training. There is no ideal analgesic that will accomplish all that is expected in every situation. A range of drugs and delivery methods will be needed. Thus, an ‘analgesic module’ reflecting its users and the environment should be developed. The number of drugs carried should be reduced to a minimum by careful selection and, where possible, utilizing drugs with multiple delivery options.

    A strong opioid is recommended as the core drug for managing moderate or severe pain; a multimodal approach may provide additional benefits.

    References

     
    1.

    Ellerton J1, Milani M, Blancher M, Zen-Ruffinen G, Skaiaa SC, Brink B, Lohani A, Paal P. Managing moderate and severe pain in mountain rescue. High Alt Med Biol. 2014 Apr;15(1):8-14. PMID: 24673533.

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    Alan Batt

    Alan Batt

    Paramedic, educator, researcher
    Alan is a critical care paramedic, paramedic educator and prehospital researcher, currently working around the world as an educator and researcher. He has previously worked and studied across Europe, North America and the Middle East. He holds a Graduate Certificate in Intensive Care Paramedic Studies, and an MSc in Critical Care. His main interests are in care of the elderly, end-of-life care, patient safety, professionalism (including role and identity), and paramedic education.

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