METHODS: Australian-state and New Zealand ambulance service jurisdiction websites were searched between 25th January to 3rd February 2022. Pain management guidelines were included where no specific back pain guideline was found. Identified guidelines were screened, appraised using AGREE II tool and recommendations on pharmacological and non-pharmacological management of back pain, ambulance transport and alerting features were extracted, summarised, and compared to two primary care guidelines.
RESULTS: Nine guidelines were identified including four back pain and 5 pain management guidelines. All four back pain guidelines recommend paracetamol or ibuprofen as analgesic options to manage back pain. These guidelines recommend transport to the emergency department when there are alerting features for serious disease, lack of pain control or where the patient is unable to ambulate. 2 out of 9 ambulance guidelines were recommended for use in their existing format following quality appraisal using AGREE II tool. Ambulance guidelines scored significantly lower than primary care guidelines for back pain.
CONCLUSIONS: Ambulance service guidelines for back pain recommend advice, reassurance, paracetamol and referral to primary care.
方法:在2022年1月25日至2月3日之间搜索了澳大利亚州和新西兰救护车服务管辖网站。包括疼痛管理指南,但未发现具体的背痛指南。筛选了确定的指南,使用AGREEII工具和关于背痛的药理学和非药理学管理的建议进行评估,提取了救护车运输和警报特征,总结,并与两个初级保健指南进行了比较。
结果:确定了9个指南,包括4个背痛和5个疼痛管理指南。所有四个背痛指南都推荐扑热息痛或布洛芬作为治疗背痛的镇痛选择。这些指南建议在有严重疾病的警报特征时前往急诊室,缺乏疼痛控制或患者无法行走。在使用AGREEII工具进行质量评估后,建议以现有格式使用9条救护车指南中的2条。救护车指南对背痛的评分明显低于初级保健指南。
结论:针对背痛的救护车服务指南建议,放心,扑热息痛和转诊到初级保健。