Objective:
This scoping review aimed to map non-pharmacological interventions to reduce acute pain in adult victims of trauma.
Introduction:
Acute pain is a consequence of a pathological or traumatic event, and a result of invasive and non-invasive health care procedures. Acute trauma pain, as well as its treatment, is one of the least-studied areas of acute pain. Although it is responsible for pain relief among a significant number of patients, only a small percentage of patients receive non-pharmacological interventions.
Inclusion criteria:
This scoping review considered all studies conducted on adult victims of trauma, aged 18 years or over, in pre-hospital emergency care, emergency rooms, and trauma-center settings. All studies that focused on non-pharmacological interventions designed to reduce acute pain, implemented and evaluated by health professionals, of any type, duration, frequency, and intensity were considered.
Methods:
A comprehensive search strategy across 11 bibliometric databases and gray literature sources was developed. Full texts of selected citations were assessed in detail for eligibility by two independent reviewers. No other relevant studies were identified by searching the references of the included articles. Data extraction was performed independently by two reviewers using an instrument previously developed, and those reviewers were later responsible for its validation. Findings were then extracted directly into tables that are accompanied by a narrative summary to show how they relate to the objectives of the review conducted.
Results:
This scoping review was based on nine different studies that included two retrospective cohort studies, five randomized controlled trials, one case report, and one literature review for five different countries. Non-pharmacological measures identified and administered to trauma victims in pre-hospital settings, emergency services, and trauma centers were: acupressure, auricular acupressure, auricular acupuncture, transcutaneous electrical nerve stimulation, repositioning, use of pressure relief devices, massage, heat therapy, music therapy, relaxation therapy, immobilization, ice therapy, compression, elevation, and bandage. Non-pharmacological interventions were mainly developed by nurses, physicians, and paramedics. They are, in most studies, poorly described in terms of their efficacy and are mostly reported in minor traumas, such as simple fractures or small wounds.
Conclusions:
Currently, there is no consensus for the implementation of non-pharmacological measures in the treatment of acute trauma pain. Their application is intended for minor traumas and their potential for the treatment of major traumas is yet unknown, which erroneously implies that they are intended exclusively for minor cases. No studies on the use of non-pharmacological interventions aimed at reducing the impact of traumatic adverse environments were identified. Further investigation on the effects of these interventions should be encouraged, so that robust decisions and recommendations can be made.
Correspondence: Mauro A.L. Mota, maurolopesmota@gmail.com
The authors declare no conflict of interest.
© 2021 Joanna Briggs Institute.