Emergency medicine clinics of North America
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Pain measurement and relief is complex and should be a priority for prehospital providers and supervisors. The literature continues to prove that we are poor pain relievers, despite the high prevalence of pain in the out-of-hospital patient population. Lack of education and research, along with agent availability, controlled substance regulation, and many myths given credence by health care providers, hinder our ability to achieve adequate pain assessment and treatment in the prehospital setting. ⋯ Nonpharmacologic therapies must also be taught and reinforced as important adjuncts to pain management. Finally, formation of quality improvement pain programs that evaluate patient outcomes and provider practice patterns will help EMS systems understand the pain management process and outline areas for improvement. Only through emphasis on pain education, research, protocol and program monitoring development will the quality of pain assessment and management in the prehospital setting improve.
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Emerg. Med. Clin. North Am. · May 2005
ReviewComplementary and alternative pain therapy in the emergency department.
One primary reason patients go to emergency departments is for pain relief. Understanding the physiologic dynamics of pain, pharmacologic methods for treatment of pain, as well CAM therapies used in treatment of pain is important to all providers in emergency care. Asking patients about self-care and treatments used outside of the emergency department is an important part of the patient history. ⋯ Adding nondrug therapies of physical therapy, cognitive-behavioral therapy, TENS, hypnosis, biofeedback, psychoanalysis, and others can complete the conventional picture. Adding in simple mind/body therapies, touch therapies, acupuncture, or others may be appropriate in select cases, and depending on the circumstances, may effect and enhance a conventional pain management program. Armed with an understanding of pain dynamics and treatments, practitioners can better meet patient needs, avoid serious side effects, and improve care when addressing pain management in the emergency department.
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Emerg. Med. Clin. North Am. · May 2005
ReviewBasic pharmacology and advances in emergency medicine.
To provide optimal pain control for their patients, emergency physicians should have an in-depth understanding of analgesic drugs and how to use and combine them effectively. The purpose of this article is to describe the pharmacology and use of analgesic agents that are most useful in the management of acute pain in the emergency department.
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Emerg. Med. Clin. North Am. · May 2005
ReviewPain assessment instruments for use in the emergency department.
Each patient's pain experience is uniquely his or her own. Standardized pain assessment methodologies and procedures provide a window to this experience and constitute a necessary first step to our understanding of pain, in both clinical and research settings. ⋯ This article provides information on a number of assessment techniques that are appropriate for clinical and research use. Their use should inform our practice and lead to continuous improvements in our management of pain.
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Emerg. Med. Clin. North Am. · May 2005
ReviewEstablishing an emergency department pain management system.
Any ED system for the management of pain in the ED should consider the following: assessment of pain including mandatory use of some assessment tool, a guideline for treatment of pain, communication with other members of the health care team, assessment tools, program monitoring, and a continuous quality assurance program. The treatment guideline should consider acute versus chronic pain, potential medication tolerance, concurrent anxiety and psychiatric issues, special populations, and disease-specific conditions.