Smertelindring i Alpin Redning. -En kvantitativ kartlegging av pasienter med akutte smerter i frivillig redning.

Abstract

Bakgrunn: Norske Alpine Redningsgrupper (NARG) er involvert i redningsaksjoner med hardt skadde pasienter med potensielt sterke smerter. Medlemmene i NARG er ofte ikke-helsepersonell uten mulighet til å administrere sterke smertestillende til den nødstedte. Studiens hensikt: Å kartlegge erfaringene medlemmene i NARG har med å evakuere pasienter med sterke smerter. Studien undersøker omfanget av evakueringer og om pasientenes sterke smerter forsinker og påvirker evakueringen. Metode: Tverrsnittsundersøkelse som ved hjelp av et elektronisk spørreskjema, distribuert via e-post kartlegger NARG-personell sine erfaringer i retrospekt. Data ble analysert i SPSS og beskrevet ved hjelp av deskriptiv statistikk. Resultat: Spørreundersøkelsen viste at en tredjedel av respondentene hadde evakuert pasienter med sterke smerter siste fem år. En klar overvekt av respondentene har erfart at pasientens sterke smerter har forsinket eller komplisert evakueringen og at sterke smertestillende vil ha god effekt. En fjerdedel (26 %) av respondentene er helsepersonell. Konklusjon: Studien viser at NARG-personell relativt ofte må evakuere pasienter med sterke smerter og at pasientens sterke smerter forsinker eller kompliserer evakueringen. At denne pasientgruppen ikke blir adekvat smertelindret er et etisk paradoks som kan løses.

Background: Norwegian Alpine Rescue Groups (NARG) are involved in rescue missions to evacuate injured patients with potentially strong pain. Members of NARG are experienced mountaineers but are generally not health professionals and are, therefore, unable to administer strong analgetics. Aim: The aim of the study was to investigate members of NARG`s experience with evacuating patients with severe traumatic pain during organized alpine rescue missions. The survey aimed to document the scope of NARG members´ experience in evacuating patients with severe pain and what potential ramifications it made for the rescue. Methods: A cross-sectional survey was performed through a digital questionnaire disseminated to the participants. The survey comprised items pertaining to the members' encounters with patients experiencing severe pain and the potential ramifications for the rescue process. Visual Analogue Scale (VAS) was used to score pain intensity. Data and findings were presented with descriptive and inferential statistics. Results: The study revealed that one third (36 %) of the respondents had evacuated patients with a VAS score ≥4. A great majority agreed that severe pain (VAS ≥4) delayed and/or complicated the rescue operation and that potent analgetic would be advantageous. One fourth of the respondents were health care professionals. Conclusion: The findings indicate that there is a relatively high incidence of evacuations involving patients with a VAS score ≥4 in alpine rescue missions in Norway, and that the patient’s severe pain delayed and complicated rescue operations. That patients in alpine rescue are getting inadequate analgesia is a resolvable paradox that can be solved.