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PP14 An observational study to describe the clinical and demographic characteristics of adult patients requiring ambulance care for non-traumatic back pain (NTBP) in Scotland
  1. Christopher Aitchison1,
  2. Kathleen Stoddart,
  3. Josie Evans,
  4. David Fitzpatrick,
  5. Tony Robertson2
  1. 1Scottish Ambulance Service, Scotland UK
  2. 2University of Stirling, Scotland UK


Background Non-Traumatic Back Pain (NTBP) is perceived as a common low acuity condition presenting to UK ambulance services. Recent evidence suggests that NTBP may be safely treated in an out-of-hospital setting, avoiding Emergency Departments. However, little published evidence is available on this patient population’s demographic and clinical characteristics, essential to inform future clinical guidelines. This study sought to i) establish the demographic and clinical characteristics of patients presenting to the Ambulance Service with NTPB; ii) determine the positive predictive value (PPV) for ambulance clinicians’ diagnosis of true NTBP (dorsalgia); iii) identify common pain relief measures used to treat these patients.

Methods An observational study of all calls made to SAS in 2018-19.

Results There were 8824 patients included in this study. More females (55.8%, 4927) made calls for NTBP than males (44.2%, 3897). The median age of all patients was 60 years (range 43-77). Ten percent (882) of patients made more than one call for NTBP within the same 12-month period. Fifty percent of patients (4303) lived in the most deprived areas of Scotland (SIMD 1 and 2). Clinically, 8542 patients had a complete first NEWS recorded: 49% (4215) with a score of 0, 35% (2940) NEWS of 1-6, and 16% (1403) with a NEWS ≥ 7. The PPV for ambulance clinicians’ diagnosis of dorsalgia was 20.4%. Common pain relief methods recorded included Entonox 54% (2409), morphine 24% (1055), paracetamol 13% (568), and ibuprofen 6% (286).

Conclusion Calls for NTBP span all age groups in the adult population however, proportionately more females required SAS support. Medium to high clinical risk was reported in one-third of patients suggesting not all NTBP were low acuity. In this study ambulance clinician’s ability to diagnose true NTBP (dorsalgia) was determined. This identified some priority areas for further research.

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