Résumé
In prehospital emergency medicine, pain is a frequent reason why the mobile emergency and resuscitation service (SMUR) intervene. However, pain assessment is not systematic and leads to oligoanalgesia of patients in pain. Method: this study is a regional multicenter observational retrospective cohort study conducted in the emergency department of the Montpellier University Hospital and Occitania region from January 1, 2024 to June 1, 2024. The main objective of this study was to describe the rate of patients treated in SMUR in Occitania for a painful reason receiving analgesic treatment. The secondary objectives were to describe the rate of patients with pain benefiting from an assessment of pain by registered in the medical record, to describe the use of analgesics by level and the rate of concordance with recommendations in terms of analgesia administered according to the assessment of pain by numerical scale (EN), and to look for factors associated with the administration of analgesics according to characteristics specific to the prehospital intervention or to the patient. Results: three thousand seventy-three patients were included, 2,494 (82%) were over 40 years old and 1,868 (61%) were men. The number of patients treated in SMUR for a painful reason receiving analgesic treatment registered in the medical record was 870 (28%) (95% CI [27%; 30%]). The number of patients with pain assessment by EN registered in the medical record was 675 (22%) (95% CI [21%; 23%]). The factors independently associated with the fact of not receiving analgesics were the lack of pain assessment by EN (OR 3.80; 95% CI: [2.86-5.06]), age group 60 to 70 years (OR 0.28; 95% CI: [0.09-0.83]), age group 70 to 80 years (OR 0.29; 95% CI: [0.10-0.85]), age group 80 to 90 years (OR 0.25; 95% CI: [0.08-0.75]). Conclusion: we showed that only 28% of patients treated in SMUR for a painful reason received analgesic therapy registered in the electronic medical record. Pain assessment by EN was performed and registered in the electronic medical record for 22% of patients. Painful patients for whom EN was quantified more often received analgesic therapy during prehospital care. Analgesia was linked to age group and less frequent in painful patients aged sixty to ninety years.