Alvaro Miguel Goncalves Sales Gomes, Ana Paula Morais de Carvalho Macedo
Abstract: The present integrative literature review aims to review the guidelines for the intervention of nurses in pain management in an out-of-hospital context and to perform a critical analysis of the protocols of action in the pharmacological treatment of pain, in different contexts. A research of works in repositories and databases, with a total number of seventeen selected articles, with a chronological filtering of the last five years and compared ten guidelines on the pharmacological treatment of pain in out-of-hospital emergency. Addressed the conceptualization of out-of-hospital emergency pain, its undervaluation, barriers and guidelines for non-pharmacological treatment, all guidelines oriented to pharmacological treatment, pain in adults and nine guidelines for the treatment of pain in children. Paracetamol is recommended for mild pain in adults and children. In the treatment of moderate and severe pain, morphine and fentanyl are mostly indicated drugs, as well as the use of fentanyl in the treatment of severe pain in children. There is a need to improve pain management for the person in a critical situation. According to the best evidence, all guidelines guide the use of opioid as treatment of moderate to severe pain, where the most used drug is fentanyl, either in adults or children. In Portugal, fentanyl is not yet recommended in the guidelines applied.
Keywords: Pain management, out-of-hospital emergency nurse, analgesia protocol, attitudes and practices