How Do the M5-50 Domains of Agreeableness, Conscientiousness, and Neuroticism Impact Oligoanalgesia in Paramedic Students on Field Placement? 

Introduction: Out-of-hospital analgesia administration for patients with pain from traumatic injuries is low and differs by variables such as patient age, gender, and ethnicity. The relationship between affective characteristics of the provider and the rate of out-of-hospital analgesia administration has not been thoroughly explored. The aim of this study was to assess the association between the M5-50 domains of agreeableness, conscientiousness, and neuroticism, as utilized by Fisdap (an online EMS database) and the administration of analgesic medications to trauma patients by paramedic students during field placements. 

Hypothesis: Students who score high in the domains of agreeableness and conscientiousness on the Paramedic Entrance Exam administer analgesia more often than those with lower scores, while those with high scores in neuroticism administer analgesia less often than those with low scores. 

Methods: A retrospective review of Fisdap paramedic student records from 2017–2019 was conducted. Records with complete entrance exam data and at least one field contact with a trauma impression were included. Records with airway interventions were excluded, as these procedures are more likely in patients who are not alert. Independent variables included scores for agreeableness, conscientiousness, and neuroticism. The outcome variable was the analgesia administration rate by paramedic students. Spearman’s correlation coefficients were used to assess the relationship between each affective characteristic and analgesic administration rate. 

Results: Records for 9,923 trauma encounters documented by 562 students representing 66 paramedic education programs were included. Encounters per student ranged from 1 to 66 with a median of 16 (IQR: 11–23). Overall, 32% (n = 3,209) of patients were administered one or more analgesic agents. The median rate of analgesic administration per student was 29% (IQR: 14%–46%). No statistically significant relationship between agreeableness (rho = 0.014, p = 0.740), conscientiousness (rho = 0.0602, p = 0.154), or neuroticism (rho = [-0.0215], p = 0.611) and the rate of analgesia administration was observed. 

Conclusion: While oligoanalgesia represents an area of concern in out-of-hospital care, no statistically significant relationship between agreeableness, conscientiousness, or neuroticism and analgesia administration rate was observed. Limitations include the retrospective data and potential for limited influence on decision to administer analgesia by paramedic students during field placements.