Analgesia in trauma patients treated by advanced life support nursing units: a retrospective pre-post intervention observational study.

There was no control group, and pain was compared only before and after treatment, so the reduction cannot be separated from time, transport, or other emergency care. The study was retrospective and used convenience records, and only patients with complete initial and final pain scores and recorded analgesia were included. Pain was measured with a subjective Verbal Numerical Rating Scale, which may vary with patient understanding, observer variation, language, and culture. Analgesics were grouped into broad categories, and exact doses and concentrations were not verified, so differences between specific drugs or dosing strategies cannot be determined. The time between pain assessments was not recorded precisely; arrival at the scene and hospital transfer were used as proxies, which may bias the measured pain change. Only immediate adverse events were assessed, and late adverse events recorded in hospital records were not included. It was conducted in two advanced life support nursing units in a Spanish region, so results may not apply where nurses do not have the same training, telemedicine prescribing support, or monitoring.

Do not conclude that nurse-led IV analgesia caused the pain reduction or that opioids are proven better than non-opioid analgesics for all trauma pain. This was a retrospective pre-post study with no control group, no randomisation, broad drug categories, unverified doses, and subjective pain scores, so the observed fall from 8.48 to 4.09 could be influenced by time, transport, or other care.