Knowledge of Morphine Administration by Ambulance Paramedics: A Comparison of Two Clinical Levels of Paramedics

摘要

Objective: The purpose of this study is to identify any differences in adherence to morphine administration protocols between two clinical levels of paramedics within one emergency medical system in Australia. Methods: The participants were made up of 63 Advanced Care Paramedics (ACPs) who were trained in basic and intermediate life support and 45 Intensive Care Paramedics (ICPs) who were trained in advanced life support skills; all were operational and practicing paramedics qualified in morphine administration. Participants were required to complete a survey designed to assess their knowledge of morphine drug therapy protocol (DTP). The survey involved two sections: 1) demographics, and 2) questions related to two scenario-based cases. Scenario one was a cardiac case and scenario two was a pediatric case. Results: In scenario one, more intensive care paramedics administered the correct dose than the advanced care paramedics (25.4% vs. 4.4%; df = 101, P = 0.002); scenario two showed no statistically significant difference between the two groups (35.5% vs. 31.6%; df = 97, P = 0.3). Conclusion: The comparison of the two levels of paramedics and their adherence to drug protocols identified that ICPs had a higher rate than ACPs for adherence to morphine administration protocols for patients suffering cardiac related chest pain. The clinical differences may be based on the length of the opioid-administration training program, clinical exposure to morphine administration, work experience and length of qualifications as an ACP or ICP. Our findings suggest that there is a need for structured initial and ongoing continuing education programs in pain management to maintain knowledge and behavior in pain management strategies. Further research is also required into paramedic’s behavioral intention regarding morphine administration to also identify what constructs affect their intent to administer morphine.