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Analgesia in the accident and emergency department: do SHOs have the knowledge to provide optimal analgesia?
  1. S Sandhu,
  2. P Driscoll,
  3. J Nancarrow,
  4. D McHugh
  1. Department of Emergency Medicine, Hope Hospital, Salford, Manchester, UK.


    OBJECTIVE: To assess senior house officers' knowledge in prescribing emergency analgesia for acute presentations in the accident and emergency (A&E) department. DESIGN: Prospective telephone survey of a defined population of SHOs, using a standardised structured questionnaire, in the months of October and November, 1995; 231 SHOs from 215 A&E departments were interviewed. The questionnaire required responses to hypothetical scenarios. A six member expert panel from the local region was consulted for suggestions for appropriate responses. MAIN OUTCOME MEASURES: Comparisons between SHO responses and those of an expert panel. RESULTS: For choice of analgesic agent, 83% of SHO responses were appropriate, for route of administration 57%, and for the dose of drug 34%. The scenario with the best overall response was a sprained ankle. The paediatric case with partial burns faired worse. Responses to a myocardial infarction scenario were the most consistent. CONCLUSIONS: A&E SHOs lack knowledge and confidence when asked to prescribe emergency analgesia for acute conditions. Responses to certain scenarios were extremely varied, indicating a need for national analgesia guidelines and protocols. Recognised training in pain management should be more readily available.

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