Prescribing of analgesics in trauma patients

Objective: To evaluate whether initial orders of pain medications by physicians for trauma patients were in accordance with published guidelines. Design: Concurrent, nonrandomized investigation conducted over 4 months. Materials and Methods: All adult trauma patients admitted to the intensive care unit within 12 hours of injury who stayed for at least 1 hour were eligible for study admission. Patients with injuries prohibiting accurate pain assessment (e.g., Glasgow Coma Score <8, spinal cord injury) were excluded. Initial orders for pain medications were compared to published guidelines; correlations between dose and patient demographics were studied. Results: Of the 30 patients enrolled in the study, 83% were prescribed appropriate pain control regimens. The average dose of morphine administered during each of the 8-hour dosing intervals was approximately 12 mg. No relationship was found between patient age, sex, Glasgow Coma Score, and morphine dose; however, there was a positive correlation found between Injury Severity Score and dose. Conclusions: The majority of patients in this investigation were initially prescribed appropriate doses and intervals for pain management.