How much do soldiers know about the morphine they carry on operations? A questionnaire study of knowledge and understanding of the morphine auto-injector on Op HERRICK 17

Introduction: Morphine auto-injectors are issued to all British soldiers on operations in Afghanistan who deploy forward of Camp Bastion, the main British base. Previous studies have reviewed the effectiveness of various pre-hospital analgesics, but there is no record of the knowledge and confidence of the relatively medically untrained soldiers who carry and use intramuscular morphine on the battlefield. The aim of this study was to assess soldiers' knowledge and confidence of the morphine auto-injector with a view to guiding further training.

Methods: Structured questionnaire distributed to soldiers in two patrol bases in Helmand Province during Op HERRICK 17.

Results: 232 questionnaires were completed by a range of ranks and trades. 100% had received mandatory training on the auto-injector and over 70% had received more advanced training. Confidence in using the auto-injector was high, with 47% rating their confidence level as 10/10. Overall, factual knowledge was good with the mean score for the questionnaire being 7.9/10; 95% of respondents knew how to document the use of morphine and 79% knew when a second dose could safely be administered. Some misunderstanding of contraindications was revealed: 9% of answers were incorrect, and 47% wrongly answered that administering morphine to a patient changes the triage category.

Conclusions: The majority of soldiers received far more than the minimum required training on the use of the morphine auto-injector. Confidence in using the device is high and generally knowledge is good. The authors suggest that deployed medical personnel in forward locations maintain regular training to soldiers on the morphine auto-injector in order to ensure that casualties receive analgesia appropriately and promptly.