Acute Care: Pain Management

2020 ◽  
Author(s):  
Claudia Ranniger
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Regional Anesthesia ◽  
Acute Pain ◽  
Management Practices ◽  
Rating Scale ◽  
Hand Position ◽  
Ultrasound Guided ◽  
The Face ◽  
Ed Visits

Pain is a chief complaint in more than 50% of emergency department (ED) visits. Injury accounts for approximately one-third of presentations associated with pain; other common diagnoses include neck and back pain, minor infections, abdominal pain, and headache. In the ED, pain is underdiagnosed and undertreated, and existing pain management practices in the ED are inconsistent.  Inadequate pain management is common, and pain remains unchanged or worsens during the ED visit for more than 40% of patients.  Patient satisfaction improves when expectations for pain control are met. This review covers the pathophysiology of pain and the practice of pain management. Figures show the approach to pain management in the ED, an example of a numerical and visual analog scale pain rating scale, field block of the pinna, ultrasound probe and hand position for ultrasound-guided regional anesthesia, regional anesthesia of the face, innervation of the hand and fingers, regional anesthesia of the median, radial and ulnar nerves, innervation of the foot, ultrasound-guided regional anesthesia of the posterior tibialis nerve, regional anesthesia of the sural nerve, and method of regional anesthesia of the dorsal foot.  This review contains 13 figures, 16 tables, and 72 references. Key words: Acute pain, Pain management, Oligoanalgesia, Pain assessment, Inadequate pain management, Acute pain management, Pain management in the emergency department, Pain in the ED, Pain presentation

Acute Care: Pain Management

2019 ◽  
Author(s):  
Claudia Ranniger
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Regional Anesthesia ◽  
Acute Pain ◽  
Management Practices ◽  
Rating Scale ◽  
Hand Position ◽  
Ultrasound Guided ◽  
The Face ◽  
Ed Visits

Pain is a chief complaint in more than 50% of emergency department (ED) visits. Injury accounts for approximately one-third of presentations associated with pain; other common diagnoses include neck and back pain, minor infections, abdominal pain, and headache. In the ED, pain is underdiagnosed and undertreated, and existing pain management practices in the ED are inconsistent.  Inadequate pain management is common, and pain remains unchanged or worsens during the ED visit for more than 40% of patients.  Patient satisfaction improves when expectations for pain control are met. This review covers the pathophysiology of pain and the practice of pain management. Figures show the approach to pain management in the ED, an example of a numerical and visual analog scale pain rating scale, field block of the pinna, ultrasound probe and hand position for ultrasound-guided regional anesthesia, regional anesthesia of the face, innervation of the hand and fingers, regional anesthesia of the median, radial and ulnar nerves, innervation of the foot, ultrasound-guided regional anesthesia of the posterior tibialis nerve, regional anesthesia of the sural nerve, and method of regional anesthesia of the dorsal foot.  This review contains 13 figures, 15 tables, and 71 references. Key words: Acute pain, Pain management, Oligoanalgesia, Pain assessment, Inadequate pain management, Acute pain management, Pain management in the emergency department, Pain in the ED, Pain presentation

scholarly journals Acute Pain Assessment Inadequacy in the Emergency Department: Patients’ Perspective

2022 ◽  
Vol 9 ◽  
pp. 237437352110496
Author(s):  
Jenni Hämäläinen ◽  
Tarja Kvist ◽  
Päivi Kankkunen
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Acute Pain ◽  
Pain Assessment ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Numerical Rating ◽  
Emergency Department Patients ◽  
Pain At Rest ◽  
Patients Perspective

For many patients, acute pain is a common cause to seek treatment in an Emergency Department (ED). An inadequate assessment could cause inappropriate pain management. The aim of this study was to describe and explain patients’ perceptions of acute pain assessment in the Emergency Department. The data were collected from ED patients (n = 114). Patients reported that nurses were asking about intensity of pain at rest, but only 52% during movement. According to the patients, the most common tools to assess acute pain were the verbal rating scale (VRS; 54% of patients), numerical rating scale (NRS; 28% of patients), and visual analogue scale (VAS; 9.7% of patients). Over twenty per cent of patients stated that ED nurses did not ask about the intensity of pain after analgesic administration. Twenty-four per cent of the patients were not pleased with nursing pain assessment in the ED. The assessment of acute pain is still inadequate in the ED. Therefore, ED nurses need to be more attentive to systematic acute pain management of patients in the ED.

scholarly journals Identification of teaching priorities for ultrasound-guided regional anesthesia as first-line pain management in a swiss university emergency department

2016 ◽  
Vol 4 (1) ◽  
pp. 2 ◽  
Author(s):  
Eckehart Schöll ◽  
Dieter Kolleth ◽  
Gilbert Krähenbühl ◽  
Christian H Nickel ◽  
Roland Bingisser
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Regional Anesthesia ◽  
Ultrasound Guided ◽  
First Line

Acute pain management in trauma: anatomy, ultrasound-guided peripheral nerve blocks and special considerations

2019 ◽  
Vol 85 (7) ◽  
Author(s):  
Theodosios Saranteas ◽  
Iosifina Koliantzaki ◽  
Olga Savvidou ◽  
Marina Tsoumpa ◽  
Georgia Eustathiou ◽  
...  
Keyword(s):  
Pain Management ◽  
Peripheral Nerve ◽  
Acute Pain ◽  
Ultrasound Guided ◽  
Acute Pain Management ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks

scholarly journals Knowledge, attitudes, and practices of Cameroonian physicians with regards to acute pain management in the emergency department: a multicenter cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Paul Owono Etoundi ◽  
Junette Arlette Metogo Mbengono ◽  
Ferdinand Ndom Ntock ◽  
Joel Noutakdie Tochie ◽  
Dominique Christelle Anaba Ndom ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Acute Pain ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Acute Pain Management ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Knowledge Attitudes And Practices

scholarly journals Commonly Used Agent for Acute Pain Management of Sickle Cell Anemia in Saudi Emergency Department: a Narrative Review

2021 ◽  
Author(s):  
Reem A. Hejazi ◽  
Nameer A. Mandourah ◽  
Aryaf S. Alsulami ◽  
Hussain T. Bakhsh ◽  
Reem M. Diri ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Acute Pain ◽  
Narrative Review ◽  
Acute Pain Management

Lidocaine Adrenaline Tetracaine Gel Versus Tetracaine Adrenaline Cocaine Gel for Topical Anesthesia in Linear Scalp and Facial Lacerations in Children Aged 5 to 17 Years

PEDIATRICS ◽  
1995 ◽  
Vol 95 (2) ◽  
pp. 255-258 ◽  
Author(s):  
Amy A Ernst ◽  
Eduardo Marvez ◽  
Todd G. Nick ◽  
Eric Chin ◽  
Edmond Wood ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Emergency Department ◽  
Inner City ◽  
Rating Scale ◽  
Topical Anesthesia ◽  
Random Numbers ◽  
Study Objective ◽  
The Face ◽  
Double Blinded

Study objective. The purpose of the present study is to compare LAT gel (4% lidocaine, 1:2000 adrenaline, 0.5% tetracaine) to TAC gel (0.5% tetracaine, 1:2000 adrenaline, 11.8% cocaine) for efficacy, side effects, and costs in children aged 5 to 17 years with facial or scalp lacerations. Design. Randomized, prospective, double-blinded clinical trial. Setting. Inner-city Emergency Department with an Emergency Medicine residency program. Patients or other participants. Children aged 5 to 17 years with linear lacerations of the face or scalp. Intervention. After informed consent was obtained patients had lacerations anesthetized with topical TAC or LAT gel according to a random numbers table. Measurements and main results. A total of 95 patients were included in the statistical analysis with 47 receiving TAC and 48 receiving LAT. Physicians and patients/parents separately rated the overall pain of suturing using a modified multidimensional scale for pain assessment specifically for children. Patients/parents also stated the number of sutures causing pain. The power of the study to determine a ranked sum difference of 15 was 0.8. Multidimensional rating scale results and number and percentage of sutures causing pain were compared using Wilcoxon's rank sum test. According to patients no difference could be detected in percent of sutures causing pain in the LAT versus TAC group (P = .51). Using the multidimensional scale, physicians and patients/parents found LAT statistically the same as TAC in effectiveness (P = .80 for physicians and P = .71 for patients). Cost per application was $3.00 for LAT compared to $35.00 for TAC. Follow-up was accomplished in 85 of 95 participants in the study with no reported complications for either medication. Conclusion. LAT gel worked as well as TAC gel for topical anesthesia in facial and scalp lacerations. Considering the advantages of a noncontrolled substance and less expense, LAT gel appears to be better suited than TAC gel for topical anesthesia in laceration repair in children.

149 Pain Management Practices in the Emergency Department: 10 Years of Experience in an Academic Center

2011 ◽  
Vol 58 (4) ◽  
pp. S227 ◽  
Author(s):  
O. Cinar ◽  
J. Blankenship ◽  
D. Fosnocht ◽  
J. White ◽  
L. Rogers ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Management Practices ◽  
Years Of Experience ◽  
Academic Center

Ultrasound-Guided Regional Anesthesia of the Femoral Nerve in the Pediatric Emergency Department

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Michael A. Heffler ◽  
Julia A. Brant ◽  
Amar Singh ◽  
Amanda G. Toney ◽  
Maya Harel-Sterling ◽  
...  
Keyword(s):  
Emergency Department ◽  
Regional Anesthesia ◽  
Femoral Nerve ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Ultrasound Guided
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