Hospital and Telephone Triage

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Analgesia in triage

Video 12 of 91
2 min 52 sec
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Can you explain to me some of the options, some of the tools you have got regarding analgesia with your role and with the triage role itself?

So in triage people will sometimes take pain relief as soon as they have injured themselves, as soon as they have felt pain, some people do not want to take pain relief for various reasons, but what we have in triage is something called a patient group directive, where you receive training on paracetamol and ibuprofen and you sign that you will follow the training before you give paracetamol or ibuprofen to a patient. All it does is saves writing out a prescription for every patient because you are supplying a medication there. So usually in triage patients can have paracetamol or ibuprofen. Having said that, all the risks about that medication need to be taken into account, how much paracetamol have they had before? Do they have any stomach ulcers regarding ibuprofen or any gastric problems?

So a good history taking is important to get that information before we make any decisions about pain relief in the first place?

That is right. There is also, there is the pathway that they go down, they may have an intravenous needle placed in their arm where they can have morphine, liquid morphine or another pain relief directly into the bloodstream.

That would not be done here by you, though, that would be done on their pathway when the triage has put them down a pathway, that pathway would then lead to higher strengths and bigger doses of pain relief for their condition.

That is right, that is right. So the sooner they get on that pathway the sooner they get effective pain relief that could not be given in triage anyway, and it is another way of prioritising patients.

Are there any other simpler techniques that we can use for easing pain that come to mind?

Yes, there are always positional and comfort measures that can be given. So somebody who has broken their wrist and they are holding their wrist or they are letting it dangle, give a broad arm sling and it supports the limb and keeps it still, so that will go some way towards giving them some kind of pain relief. Any lower limb problems, you can elevate the limb and that can reduce pain as well, so those comfort measures can go a long way without resorting to medication.

Do you find also that just reassurance and talking to patients can quite often a placebo type effect? Do you find that works effectively?

Absolutely, yeah. Again, pain is subjective, it involves feelings and you can affect those feelings by what you say and how you behave around people.