Abstract
Background
Lower back pain (LBP) is the leading cause of disability globally and can be distressing for patients. It is commonly reported that serious pathologies underlying LBP are rare and most patients would be more appropriately managed in primary care. However, recent literature suggests patients accessing emergency care may differ from those accessing primary care. Currently, little is known about the use of ambulance services by people with LBP. The aim of this study was to investigate the extent and nature of ambulance services utilisation by patients presenting with LBP.
Methods
This observational study is a retrospective analysis of ambulance service calls in the North East of England presenting with LBP from 01/08/2016 to 31/07/2017 (Health Research Agency registration 17/WS/0216).
Results
Of 484,495 answered calls, 3,315 calls (0.7%) were categorised as initially presenting with LBP. Women represented 59% of callers. Most calls were from those aged 41-50 and 71-80 years-old. Almost half of patients (48%) initially presenting with LBP were later categorised with a problem elsewhere. 49% of patients received analgesia, including Entonox (24%) and morphine (13%). Most patients (69%) were transported to an Emergency Department (ED) while 28% remained at home.
Conclusion
LBP is a relatively common reason to call the ambulance service. Contrary to data from primary care non-spinal causes, which include medical emergencies, make up a significant proportion of this. Guidance should be updated to consider emergency care patients to ensure the higher percentage of emergency causes are identified and managed appropriately.
Lower back pain (LBP) is the leading cause of disability globally and can be distressing for patients. It is commonly reported that serious pathologies underlying LBP are rare and most patients would be more appropriately managed in primary care. However, recent literature suggests patients accessing emergency care may differ from those accessing primary care. Currently, little is known about the use of ambulance services by people with LBP. The aim of this study was to investigate the extent and nature of ambulance services utilisation by patients presenting with LBP.
Methods
This observational study is a retrospective analysis of ambulance service calls in the North East of England presenting with LBP from 01/08/2016 to 31/07/2017 (Health Research Agency registration 17/WS/0216).
Results
Of 484,495 answered calls, 3,315 calls (0.7%) were categorised as initially presenting with LBP. Women represented 59% of callers. Most calls were from those aged 41-50 and 71-80 years-old. Almost half of patients (48%) initially presenting with LBP were later categorised with a problem elsewhere. 49% of patients received analgesia, including Entonox (24%) and morphine (13%). Most patients (69%) were transported to an Emergency Department (ED) while 28% remained at home.
Conclusion
LBP is a relatively common reason to call the ambulance service. Contrary to data from primary care non-spinal causes, which include medical emergencies, make up a significant proportion of this. Guidance should be updated to consider emergency care patients to ensure the higher percentage of emergency causes are identified and managed appropriately.
| Original language | English |
|---|---|
| Pages (from-to) | 11-17 |
| Journal | British Paramedic Journal |
| Volume | 6 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 1 Mar 2022 |