| Summary: | Patient-controlled analgesia (PCA) refers to the use of a medical device that delivers defined doses of pain medication to a patient on demand. Specific doses are programmed by a health care professional, and the device is also programmed to limit the administration of each dose or a cumulative amount of drug within certain time intervals. PCA typically involves intravenous opioid delivery, but may include other drugs (such as non-steroidal anti-inflammatory drugs or local anaesthesia) or other routes of administration (for example, subcutaneous, transdermal, pulmonary or nasal administration). It is commonly used for post-operative pain, but PCA for acute pain management in the hospital emergency department has also been studied. It has been documented that acute pain is not adequately controlled in patients in pre-hospital emergency care settings. This observation of suboptimal pain management may extend to situations in which patients who require transfer from a rural or remote hospital to a higher level of care are in emergency vehicles for up to several hours. In some jurisdictions, ambulances are staffed by paramedics with basic life support training; doctors and nurses are not available to administer analgesics. Therefore, there is a potential role for PCA to provide sufficient acute pain management in this setting. The purpose of this report is to review the evidence of the clinical effectiveness and guidelines regarding PCA for patients with acute injury during transfer to a higher level of care
|
|---|