{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T17:09:32Z","timestamp":1761930572895,"version":"build-2065373602"},"reference-count":50,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2017,3,1]],"date-time":"2017-03-01T00:00:00Z","timestamp":1488326400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2017,3,1]],"date-time":"2017-03-01T00:00:00Z","timestamp":1488326400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2016,7,4]],"date-time":"2016-07-04T00:00:00Z","timestamp":1467590400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["African Journal of Emergency Medicine"],"published-print":{"date-parts":[[2017,3]]},"DOI":"10.1016\/j.afjem.2017.01.002","type":"journal-article","created":{"date-parts":[[2017,1,28]],"date-time":"2017-01-28T08:16:01Z","timestamp":1485591361000},"page":"24-29","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":7,"title":["A description of pharmacological analgesia administration by public sector advanced life support paramedics in the City of Cape Town"],"prefix":"10.1016","volume":"7","author":[{"given":"Ryan","family":"Matthews","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"McCaul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wayne","family":"Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"issue":"7","key":"10.1016\/j.afjem.2017.01.002_b0005","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1097\/AJP.0b013e3182169036","article-title":"Prevalence and relief of pain in trauma patients in emergency medical services","volume":"27","author":"Berben","year":"2011","journal-title":"Clin J Pain"},{"issue":"6","key":"10.1016\/j.afjem.2017.01.002_b0010","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1136\/emj.2010.098954","article-title":"Epidemiology of prehospital pain: an opportunity for improvement","volume":"28","author":"Jennings","year":"2011","journal-title":"Emerg Med J"},{"issue":"2","key":"10.1016\/j.afjem.2017.01.002_b0015","doi-asserted-by":"crossref","first-page":"83","DOI":"10.5603\/AIT.2014.0016","article-title":"Incidence, characteristics and management of pain in one operational area of medical emergency teams","volume":"46","author":"Kosi\u0144ski","year":"2014","journal-title":"Anaesthesiol Intensive Ther"},{"issue":"3","key":"10.1016\/j.afjem.2017.01.002_b0020","doi-asserted-by":"crossref","first-page":"334","DOI":"10.3109\/10903121003760218","article-title":"Prevalence and management of acute pain in prehospital emergency medicine","volume":"14","author":"Galinski","year":"2010","journal-title":"Prehosp Emerg Care"},{"issue":"4","key":"10.1016\/j.afjem.2017.01.002_b0025","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1111\/j.1533-2500.2009.00277.x","article-title":"Acute pain and availability of analgesia in the prehospital emergency setting in Italy: a problem to be solved","volume":"9","author":"Marinangeli","year":"2009","journal-title":"Pain Pract"},{"issue":"8","key":"10.1016\/j.afjem.2017.01.002_b0030","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1016\/j.ajem.2007.02.001","article-title":"Women are less likely than men to receive prehospital analgesia for isolated extremity injuries","volume":"25","author":"Michael","year":"2007","journal-title":"Am J Emerg Med"},{"issue":"6","key":"10.1016\/j.afjem.2017.01.002_b0035","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1111\/j.1365-2753.2009.01312.x","article-title":"Exploratory cross-sectional study of factors associated with pre-hospital management of pain","volume":"16","author":"Siriwardena","year":"2010","journal-title":"J Eval Clin Pract"},{"issue":"1","key":"10.1016\/j.afjem.2017.01.002_b0040","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1093\/bja\/aes355","article-title":"Undertreatment of acute pain (oligoanalgesia) and medical practice variation in prehospital analgesia of adult trauma patients: a 10 yr retrospective study","volume":"110","author":"Albrecht","year":"2013","journal-title":"Br J Anaesth"},{"issue":"6","key":"10.1016\/j.afjem.2017.01.002_b0045","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1097\/MEJ.0b013e32835c9fa3","article-title":"Undertreatment of pain in the prehospital setting: a comparison between trauma patients and patients with chest pain","volume":"20","author":"Bakkelund","year":"2013","journal-title":"Eur J Emerg Med"},{"issue":"4","key":"10.1016\/j.afjem.2017.01.002_b0050","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1136\/emj.2010.107094","article-title":"Determinants of clinically important pain severity reduction in the prehospital setting","volume":"29","author":"Jennings","year":"2012","journal-title":"Emerg Med J"},{"issue":"4","key":"10.1016\/j.afjem.2017.01.002_b0055","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1017\/S1049023X14000594","article-title":"An assessment of pain management among patients presenting to emergency medical services after suffering a fall","volume":"29","author":"Infinger","year":"2014","journal-title":"Prehosp Disaster Med"},{"issue":"1","key":"10.1016\/j.afjem.2017.01.002_b0060","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.jemermed.2012.07.088","article-title":"Racial differences in receiving morphine among prehospital patients with blunt trauma","volume":"45","author":"Young","year":"2013","journal-title":"J Emerg Med"},{"issue":"1","key":"10.1016\/j.afjem.2017.01.002_b0065","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.ajem.2008.01.005","article-title":"Factors associated with unoffered trauma analgesia in critical care transport","volume":"27","author":"Frakes","year":"2009","journal-title":"Am J Emerg Med"},{"issue":"8","key":"10.1016\/j.afjem.2017.01.002_b0070","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1111\/acem.12190","article-title":"Provision of out-of-hospital analgesia to older fallers with suspected fractures: above par, but opportunities for improvement exist","volume":"20","author":"Simpson","year":"2013","journal-title":"Acad Emerg Med"},{"issue":"2","key":"10.1016\/j.afjem.2017.01.002_b0075","first-page":"42","article-title":"Helicopter Winchmens\u2019 experiences with pain management in challenging environments","volume":"106","author":"van der Velde","year":"2013","journal-title":"Ir Med J"},{"issue":"4","key":"10.1016\/j.afjem.2017.01.002_b0080","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1080\/10903120090940967","article-title":"Effects of prehospital nitroglycerin on hemodynamics and chest pain intensity","volume":"4","author":"Engelberg","year":"2000","journal-title":"Prehosp Emerg Care"},{"issue":"18","key":"10.1016\/j.afjem.2017.01.002_b0085","first-page":"S787","article-title":"Part 10: acute coronary syndromes: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care","volume":"122","author":"O\u2019Connor","year":"2010","journal-title":"Circulation"},{"year":"2006","series-title":"Advanced Life Support Practitioner Protocols","author":"Professional Board for Emergency Care Providers","key":"10.1016\/j.afjem.2017.01.002_b0090"},{"key":"10.1016\/j.afjem.2017.01.002_b0095","unstructured":"Health Professions Council of South Africa. iRegister [Internet]. 2014 [cited 2014 Nov 30]. Available from: http:\/\/isystems.hpcsa.co.za\/iregister\/."},{"issue":"4","key":"10.1016\/j.afjem.2017.01.002_b0100","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/S0196-0644(96)70225-1","article-title":"Pain relief versus patient satisfaction","volume":"27","author":"Tselios","year":"1996","journal-title":"Ann Emerg Med"},{"issue":"2","key":"10.1016\/j.afjem.2017.01.002_b0105","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1067\/mem.2002.124756","article-title":"Emergency medical services outcomes project (EMSOP) IV: pain measurement in out-of-hospital outcomes research","volume":"40","author":"Maio","year":"2002","journal-title":"Ann Emerg Med"},{"issue":"6","key":"10.1016\/j.afjem.2017.01.002_b0110","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1111\/j.1553-2712.2003.tb00046.x","article-title":"IH. Acute pain is underassessed in out-of-hospital emergencies","volume":"10","author":"Luger","year":"2003","journal-title":"Acad Emerg Med"},{"issue":"1","key":"10.1016\/j.afjem.2017.01.002_b0115","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/S0736-4679(99)00153-5","article-title":"The patient vs. caregiver perception of acute pain in the emergency department","volume":"18","author":"Guru","year":"2000","journal-title":"J Emerg Med"},{"issue":"2","key":"10.1016\/j.afjem.2017.01.002_b0120","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1136\/emj.2009.079384","article-title":"The reliability of vital signs in estimating pain severity among adult patients treated by paramedics","volume":"28","author":"Lord","year":"2011","journal-title":"Emerg Med J"},{"issue":"1","key":"10.1016\/j.afjem.2017.01.002_b0125","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.jemermed.2006.05.029","article-title":"Changes in heart rate do not correlate with changes in pain intensity in emergency department patients","volume":"32","author":"Bossart","year":"2007","journal-title":"J Emerg Med"},{"year":"2010","series-title":"South African Medicines Formulary","author":"Division of Clinical Pharmacology Faculty of Health Sciences University of Cape Town","key":"10.1016\/j.afjem.2017.01.002_b0130"},{"key":"10.1016\/j.afjem.2017.01.002_b0135","series-title":"Tintinalli\u2019s emergency medicine: a comprehensive study guide","article-title":"Acute pain management in adults","author":"Ducharme","year":"2011"},{"issue":"4","key":"10.1016\/j.afjem.2017.01.002_b0140","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.annemergmed.2005.03.010","article-title":"Intravenous morphine at 0.1mg\/kg is not effective for controlling severe acute pain in the majority of patients","volume":"46","author":"Bijur","year":"2005","journal-title":"Ann Emerg Med"},{"issue":"4","key":"10.1016\/j.afjem.2017.01.002_b0145","doi-asserted-by":"crossref","DOI":"10.1016\/j.annemergmed.2006.06.030","article-title":"Randomized double-blind placebo-controlled trial of two intravenous morphine dosages (0.10mg\/kg and 0.15mg\/kg) in emergency department patients with moderate to severe acute pain","volume":"49","author":"Birnbaum","year":"2007","journal-title":"Ann Emerg Med"},{"issue":"2","key":"10.1016\/j.afjem.2017.01.002_b0150","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.ajem.2007.04.020","article-title":"Is there an ideal morphine dose for prehospital treatment of severe acute pain? A randomized, double-blind comparison of 2 doses","volume":"26","author":"Bounes","year":"2008","journal-title":"Am J Emerg Med"},{"issue":"3","key":"10.1016\/j.afjem.2017.01.002_b0155","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1155\/2015\/507470","article-title":"Use of morphine sulphate by South African paramedics for prehospital pain management","volume":"20","author":"Vincent-Lambert","year":"2015","journal-title":"Pain Res Manag"},{"issue":"9","key":"10.1016\/j.afjem.2017.01.002_b0160","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1016\/j.injury.2011.01.029","article-title":"Facilitators and barriers in pain management for trauma patients in the chain of emergency care","volume":"43","author":"Berben","year":"2012","journal-title":"Injury"},{"issue":"5","key":"10.1016\/j.afjem.2017.01.002_b0165","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1016\/j.ajem.2009.12.005","article-title":"Predictors of pain relief and adverse events in patients receiving opioids in a prehospital setting","volume":"29","author":"Bounes","year":"2011","journal-title":"Am J Emerg Med"},{"issue":"3","key":"10.1016\/j.afjem.2017.01.002_b0170","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.1136\/emermed-2012-201111","article-title":"Patients\u2019 and emergency clinicians\u2019 perceptions of improving pre-hospital pain management: a qualitative study","volume":"30","author":"Iqbal","year":"2013","journal-title":"Emerg Med J"},{"issue":"3","key":"10.1016\/j.afjem.2017.01.002_b0175","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.jen.2006.01.010","article-title":"Disparities in analgesia and opioid prescribing practices for patients with musculoskeletal pain in the emergency department","volume":"32","author":"Heins","year":"2006","journal-title":"J Emerg Nurs"},{"key":"10.1016\/j.afjem.2017.01.002_b0180","first-page":"4","article-title":"Pre-hospital clinical practice guidelines \u2013 where are we now?","author":"McCaul","year":"2016","journal-title":"Afr J Emerg Med"},{"issue":"5","key":"10.1016\/j.afjem.2017.01.002_b0185","first-page":"1048","article-title":"The value of \u201cmultimodal\u201d or \u201cbalanced analgesia\u201d in postoperative pain treatment","volume":"77","author":"Kehlet","year":"1993","journal-title":"Anesth Analg"},{"issue":"4","key":"10.1016\/j.afjem.2017.01.002_b0190","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.ajem.2006.11.016","article-title":"Management of severe acute pain in emergency settings: ketamine reduces morphine consumption","volume":"25","author":"Galinski","year":"2007","journal-title":"Am J Emerg Med"},{"issue":"6","key":"10.1016\/j.afjem.2017.01.002_b0195","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/j.annemergmed.2011.11.012","article-title":"Morphine and ketamine is superior to morphine alone for out-of-hospital trauma analgesia: a randomized controlled trial","volume":"59","author":"Jennings","year":"2012","journal-title":"Ann Emerg Med"},{"issue":"1","key":"10.1016\/j.afjem.2017.01.002_b0200","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1186\/1757-7241-17-61","article-title":"The effect of combined treatment with morphine sulphate and low-dose ketamine in a prehospital setting","volume":"17","author":"Johansson","year":"2009","journal-title":"Scand J Trauma Resusc Emerg Med"},{"issue":"5","key":"10.1016\/j.afjem.2017.01.002_b0205","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1016\/j.injury.2007.04.013","article-title":"Pain prevalence and pain relief in trauma patients in the Accident & Emergency department","volume":"39","author":"Berben","year":"2008","journal-title":"Injury"},{"issue":"1","key":"10.1016\/j.afjem.2017.01.002_b0210","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1742-6723.2009.01246.x","article-title":"Patterns of analgesia for fractured neck of femur in Australian emergency departments: original research","volume":"22","author":"Holdgate","year":"2010","journal-title":"Emerg Med Australas"},{"issue":"3","key":"10.1016\/j.afjem.2017.01.002_b0215","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.jen.2010.11.001","article-title":"Long-bone fracture pain management in the emergency department","volume":"38","author":"Minick","year":"2012","journal-title":"J Emerg Nurs"},{"issue":"6","key":"10.1016\/j.afjem.2017.01.002_b0220","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1016\/j.jpain.2006.12.005","article-title":"Pain in the emergency department: results of the Pain and Emergency Medicine Initiative (PEMI) multicenter study","volume":"8","author":"Todd","year":"2007","journal-title":"J Pain"},{"issue":"11","key":"10.1016\/j.afjem.2017.01.002_b0225","doi-asserted-by":"crossref","first-page":"1800","DOI":"10.1345\/aph.1P438","article-title":"Intravenous opioids for severe acute pain in the emergency department","volume":"44","author":"Patanwala","year":"2010","journal-title":"Ann Pharmacother"},{"issue":"3","key":"10.1016\/j.afjem.2017.01.002_b0230","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/j.ajem.2005.11.021","article-title":"Efficacy of fentanyl analgesia for trauma in critical care transport","volume":"24","author":"Frakes","year":"2006","journal-title":"Am J Emerg Med"},{"issue":"8","key":"10.1016\/j.afjem.2017.01.002_b0235","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1111\/j.1526-4637.2009.00731.x","article-title":"Pain following battlefield injury and evacuation: a survey of 110 casualties from the wars in Iraq and Afghanistan","volume":"10","author":"Buckenmaier","year":"2009","journal-title":"Pain Med"},{"issue":"6","key":"10.1016\/j.afjem.2017.01.002_b0240","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1016\/j.ahj.2005.02.010","article-title":"Association of intravenous morphine use and outcomes in acute coronary syndromes: results from the CRUSADE Quality Improvement Initiative","volume":"149","author":"Meine","year":"2005","journal-title":"Am Heart J Durham: Mosby"},{"issue":"18 Suppl 2","key":"10.1016\/j.afjem.2017.01.002_b0245","first-page":"S483","article-title":"Part 9: acute coronary syndromes","volume":"132","author":"O\u2019Connor","year":"2015","journal-title":"Circulation"},{"issue":"3","key":"10.1016\/j.afjem.2017.01.002_b0250","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/S0196-0644(96)70264-0","article-title":"Chart reviews in emergency medicine research: where are the methods?","volume":"27","author":"Gilbert","year":"1996","journal-title":"Ann Emerg Med"}],"container-title":["African Journal of Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2211419X1630074X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2211419X1630074X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T17:06:32Z","timestamp":1761930392000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2211419X1630074X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3]]},"references-count":50,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017,3]]}},"alternative-id":["S2211419X1630074X"],"URL":"https:\/\/doi.org\/10.1016\/j.afjem.2017.01.002","relation":{},"ISSN":["2211-419X"],"issn-type":[{"type":"print","value":"2211-419X"}],"subject":[],"published":{"date-parts":[[2017,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"A description of pharmacological analgesia administration by public sector advanced life support paramedics in the City of Cape Town","name":"articletitle","label":"Article Title"},{"value":"African Journal of Emergency Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.afjem.2017.01.002","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2017 African Federation for Emergency Medicine. Publishing services provided by Elsevier B.V.","name":"copyright","label":"Copyright"}]}}