Appropriate morphine administration by paramedics : a review of the literature

Objective: This paper focuses on three main areas: pain management practices for paramedics; in service continuing education programs and, possible pain-management differences between two levels of paramedics. Methods: A literature search was performed using four databases to identify literature reviews and journal articles from 1997 to 2013. The search was focused around three core areas: 1) Pre-hospital pain management 2) barriers to pain management; and 3) pain management education. There was a five stage process to identify the relevant literature based on specific terminology in the abstracts. Results: The literature search located 1240 articles, incorporating five stages with each stage having specific terms relevant to the research. Thirty two articles met the inclusion criteria. The breakdown of the articles included stage one - 6 articles, stage 2 - 10 results, stage 3 - 11 results, stage four - 5 articles and stage 5 - 0 articles. Conclusions: There remains little high-quality published evidence of systemic theoretical approach with which to validate many aspects of pain management in paramedic practice. Future research must identify if concepts taught in the classroom are being transferred to the clinical setting. Potential findings of such a study could be used to improve organisational awareness of factors that contribute to the behaviour and development of paramedics.