OBJECTIVE: To investigate the impact of liberalization of paramedic management protocols for the use of morphine sulfate (MS). METHODS: A retrospective database analysis tallied and categorized MS use into seven conditions during two intervals--six months before (control) and six months after (study) the protocol change. RESULTS: In the control interval, 760 of 34,020 (2.2%) patients received MS. In the study interval, 999 of 30,320 (3.3%) received the drug, a 50% relative increase in MS use. MS use dramatically increased in two assessment categories: other painful medical conditions (19.0% vs. 2.8% of transports, relative risk [RR] 6.8, 95% confidence interval [CI] 5.2-8.9) and nontraumatic abdominal pain (9.2% vs. 1.9% of transports, RR 4.8, 95% CI 3.3-6.9). CONCLUSION: Liberalization of pain management protocols resulted in an appreciable increase in the use of MS only in medical categories, predominantly abdominal pain, with no apparent safety or misuse issues.
OBJECTIVE: To investigate the impact of liberalization of paramedic management protocols for the use of morphine sulfate (MS). METHODS: A retrospective database analysis tallied and categorized MS use into seven conditions during two intervals--six months before (control) and six months after (study) the protocol change. RESULTS: In the control interval, 760 of 34,020 (2.2%) patients received MS. In the study interval, 999 of 30,320 (3.3%) received the drug, a 50% relative increase in MS use. MS use dramatically increased in two assessment categories: other painful medical conditions (19.0% vs. 2.8% of transports, relative risk [RR] 6.8, 95% confidence interval [CI] 5.2-8.9) and nontraumatic abdominal pain (9.2% vs. 1.9% of transports, RR 4.8, 95% CI 3.3-6.9). CONCLUSION: Liberalization of pain management protocols resulted in an appreciable increase in the use of MS only in medical categories, predominantly abdominal pain, with no apparent safety or misuse issues.