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Adequate analgesia is one of the most important interventions in emergency medicine. However, studies suggest that many patients are undertreated for pain. There can be many reasons why patients assess their pain differently to the paramedics. This study aimed to assess the differences in pain ratings between patients and paramedics and factors influencing them in prehospital emergencies. This prospective cross-sectional observational study included patients treated and transported by paramedics or paramedics and emergency physicians of the German Red Cross in Reutlingen, Germany. This study included 6,365 patients. The prevalence of pain was 49.7%. Among patients with a self-reported numerical rating scale (NRS) > 0, the mean patient pain rating was NRS 4.2 ± 2.7, while the mean paramedic pain rating was NRS 3.6 ± 2.4 (p < 0.001). Approximately 11.8% (n = 751) of patients reported subjectively unbearable pain. Patients reported a mean NRS of 7.7 ± 1.8 for unbearable pain, but a mean NRS of 3.3 ± 2.0 for bearable pain (p < 0.001). The difference in pain ratings between patients and paramedics increased with pain severity. Univariate analysis showed that there were no gender differences, but the difference in pain rating was influenced by patient age (p < 0.001) and paramedic age (p = 0.042). The differences in pain ratings were particularly pronounced for abdominal diseases (p < 0.001) and trauma (p < 0.001). There is a difference in pain ratings between patients and paramedics, which increases with pain severity and appears to be associated with the patient's age and the paramedic's age. To determine the desire and need for analgesics, the question about unbearable pain is a good addition to the NRS., (© 2024. The Author(s).)

Nanocomposite materials represent a success story of nanotechnology. However, development of nanomaterial fabrication still suffers from the lack of adequate analysis tools. In particular, achieving and maintaining well-dispersed particle distributions is a key challenge, both in material development and industrial production. Conventional methods like optical or electron microscopy need laborious, costly sample preparation and do not permit fast extraction of nanoscale structural information from statistically relevant sample volumes. Here we show that optical coherence tomography (OCT) represents a versatile tool for nanomaterial characterization, both in a laboratory and in a production environment. The technique does not require sample preparation and is applicable to a wide range of solid and liquid material systems. Large particle agglomerates can be directly found by OCT imaging, whereas dispersed nanoparticles are detected by model-based analysis of depth-dependent backscattering. Using a model system of polystyrene nanoparticles, we demonstrate nanoparticle sizing with high accuracy. We further prove the viability of the approach by characterizing highly relevant material systems based on nanoclays or carbon nanotubes. The technique is perfectly suited for in-line metrology in a production environment, which is demonstrated using a state-of-the-art compounding extruder. These experiments represent the first demonstration of multiscale nanomaterial characterization using OCT.