Efficacy and safety of intravenous sufentanil administration in low-severity acute trauma as a competence of paramedics: a follow-up observational study.
Background and importance: In the Czech Republic, paramedics are required to consult a physician before administering intravenous opioids, which may delay effective prehospital pain management. As paramedic competencies expand in Europe, it is important to evaluate the safety and efficacy of indepen...
| Publicado en: | European Journal of Trauma & Emergency Surgery Vol. 51; no. 1; pp. 1 - 8 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
9/9/2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=187841382&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 187841382 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: 9/9/2025 vid: 51 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 187841382 187841382 187841382 10.1007/s00068-025-02953-0 187841382 ppf: 1 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Efficacy and safety of intravenous sufentanil administration in low-severity acute trauma as a competence of paramedics: a follow-up observational study. aug: au: Sykora, Roman Kukackova, Nikola Sopko, Ondrej Peran, David Smetana, Jiri Renza, Metodej Kukacka, Milos affil: https://ror.org/024d6js02 Department of Anesthesia and Intensive Care, Third Faculty of Medicine, Charles University and FNKV University Hospital, Prague, Czech Republic sug: subj: Pain Drug Therapy Sufentanil Administration and Dosage Sufentanil Adverse Effects Administration, Intravenous Drug Efficacy Patient Safety Severity of Injury Paramedics Psychosocial Factors Professional Competence Professional Role Prehospital Care Human Male Female Adult Middle Age Aged Aged, 80 and Over Czech Republic Emergency Patients Prospective Studies Nonexperimental Studies Comparative Studies Electronic Health Records Emergency Medical Services Analgesics, Opioid Administration and Dosage Scales Respiration Disorders Nausea Vomiting Hypotension Pain Measurement Data Analysis Software Descriptive Statistics T-Tests Chi Square Test Fisher's Exact Test Documentation Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Background and importance: In the Czech Republic, paramedics are required to consult a physician before administering intravenous opioids, which may delay effective prehospital pain management. As paramedic competencies expand in Europe, it is important to evaluate the safety and efficacy of independent opioid administration in prehospital emergency care settings. Objectives: To assess the safety and effectiveness of intravenous sufentanil administered independently by trained paramedics compared to administration following remote physician consultation in adult trauma patients. Design: Prospective, single-center, observational cohort study. Settings and participants: Conducted at the Emergency Medical Services of the Karlovy Vary Region between January 1 and December 31, 2024. The study included 462 adult trauma patients who were hemodynamically stable and conscious. Patients were divided into two groups: the Consultation group (physician consultation required) and the Competency group (paramedics administering independently). Intervention or exposure: Intravenous administration of sufentanil, with or without physician phone consultation. Outcome measures and analysis: Primary outcomes included reduction in pain (measured using the Numeric Rating Scale, NRS) and incidence of adverse events (e.g., respiratory depression, oxygen desaturation, hypotension, and antiemetic use). Statistical significance was set at p < 0.05. Main results: Both groups achieved similar pain reduction. The Competency group received a higher mean dose of sufentanil (9.7 ± 3.0 µg vs. 8.9 ± 2.8 µg; p = 0.006) and more frequently used non-opioid adjuvant analgesics (54% vs. 41%). Documentation of pain scores was significantly better in the Competency group (87% vs. 43%; p < 0.01). Adverse events were rare, non-serious, and comparable between groups. Antiemetics were more frequently administered in the Competency group (11% vs. 6%; p = 0.037). A minor, clinically insignificant reduction in diastolic blood pressure was observed in the Competency group. Conclusion: Intravenous sufentanil administered independently by trained paramedics in adult patients with lower severity trauma demonstrated safety and effectiveness comparable to administration following remote physician consultation, along with improved documentation and increased use of multimodal analgesia. Although this was a monocentric study, these observations may contribute to ongoing discussions about expanding paramedic competencies in opioid analgesia within the Czech prehospital emergency system. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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