The PAIN Study
Research type
Research Study
Full title
Paramedic Administration of Intravenous acetaminopheN in the ambulance – a retrospective cohort study
IRAS ID
266104
Contact name
Karl Charlton
Contact email
Sponsor organisation
North East Ambulance Service NHS Foundation Trust
Duration of Study in the UK
0 years, 3 months, 7 days
Research summary
Paracetamol, known as acetaminophen, is one of the most commonly used medications for pain relief. It has several benefits; it is effective, works quickly and has minimal side effects. The United Kingdom (UK) ambulance service uses oral paracetamol and has recently introduced intravenous paracetamol.
As many as 30% of all patients who present to the ambulance service report moderate to severe pain. Effective pain management is an essential part of emergency care, and yet many patients receive inadequate pain relief in the out of hospital environment.
National UK ambulance guidance suggests intravenous morphine or paracetamol for severe pain and oral pain relief for mild to moderate pain. Local guidance provided to paramedics by North East Ambulance Service (NEAS) NHS Foundation Trust directs paramedics to provide all patients with oral paracetamol, despite severity of pain, believing oral and intravenous paracetamol are equally effective. The evidence used to underpin this guidance is weak and derives from evidence from in hospital studies, which has limited value to the out of hospital population. Paramedics are also encouraged to use their clinical judgement regarding what pain relief to use and when, which leads to variability in treatments.
There exists little knowledge upon which to guide paramedic practice regarding the use of intravenous paracetamol. The researchers suggest a retrospective cohort study to determine any benefits of oral versus intravenous paracetamol.
The researchers will request an anonymised data set from the informatics team at NEAS for the first 50 patients who received oral paracetamol and 50 who received intravenous paracetamol from January 1st 2019, aged >=18yrs, who were transported to hospital. The data set will be independently analysed by 2 blinded, researchers. The researchers will not approach any potential participants and it will not be possible to identify any individual from the data or any results.
REC name
North East - Newcastle & North Tyneside 1 Research Ethics Committee
REC reference
19/NE/0197
Date of REC Opinion
7 Jun 2019
REC opinion
Favourable Opinion