Introduction of Penthrox pain relief
Jonathan Jones, Assistant Corporate Secretary, Welsh Ambulance Services University NHS Trust
Introduction
Managing pain for trauma patients is crucial for care quality and patient experience. Delays in community pain relief, especially for injuries like fractured hips, are distressing for patients and responders alike. Community First Responders (CFRs), who handle over 10,000 emergency calls annually, currently lack access to analgesia, limiting their ability to alleviate pain. Introducing inhaled analgesia would empower CFRs to provide immediate pain relief, improving patient comfort and supporting families and carers while awaiting further medical assistance.
Methods
- Introduced inhaled analgesia for all CFRs within a governed clinical framework.
- Established a clinical task and finish group in November 2022 with key stakeholders and clinical leads.
- Set up a national purchasing and logistical infrastructure for volunteers across Wales.
- Managed the project using PRINCE2 methodology with a project lead and senior responsible officer.
- Weekly meetings included formal agendas, action logs, risk register, highlight reports, and stakeholder responsibilities.
- Task group addressed legal, financial, environmental, logistical, and training aspects for over 600 volunteers.
- Despite challenges, the group focused on improving patient care and supporting volunteers.
Outcomes
“I have used it and have only positive things to say about it!"
- 600 volunteers trained and assessed in safe administration of analgesia within a clinically governed education framework.
- Training included in CFR induction programmes and offered online and face-to-face, with competency assessments.
- First trained volunteers went live in May 2023, alongside the new electronic patient care record system.
- Since May 2023, 5655 units of Penthrox administered by volunteers and WAST staff.
- August 2023 audit showed 95.7% compliance with protocol, with clinical review and learning for the 4.3% administered outside protocol.
Learnings
- Volunteers are highly proactive and engaged, providing essential patient care support.
- Introducing analgesia was timely and necessary, enhancing volunteers' ability to help patients effectively.
- Underestimated volunteer and staff eagerness for training; achieved 71-93% compliance across Health Boards by May 2023.
- Faced challenges in procurement, storage, and distribution, but collaboration within NHS ensured smooth rollout.
- Data collection was initially challenging due to new electronic patient records.
- The clinical audit process has been a valuable safety mechanism and clinical governance assurance.
What next?
- Opportunities to enhance volunteer skills and offer to communities.
- Working on a consultation process with patients to enable feedback.
- National approach allows sharing of processes and learning across the UK.
