The American journal of emergency medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
Transcutaneous electrical nerve stimulation versus oral analgesic: a randomized double-blind controlled study in acute traumatic pain.
A double-blind controlled analgesic study was undertaken in outpatients suffering acute traumatic pain. One hundred patients completed the study and were randomly assigned to four treatment groups, each receiving either functioning transcutaneous electrical nerve stimulators (TENS), placebo TENS, acetaminophen with codeine and a functioning TENS, or acetaminophen with codeine and a placebo TENS. ⋯ The TENS was approximately as effective as acetaminophen (300-600 mg) with codeine (30-60 mg) but had no side effects. Transcutaneous electrical nerve stimulators have been shown to be effective in the management of acute traumatic pain and may be indicated for patients who cannot be given medications.
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With regionalization of specialized health care services, some patients must be transferred between hospital to receive needed care. The authors evaluated 100 transfers to their emergency department as to the adequacy of stabilization prior to transport. Problems were identified in the areas of communication (nine cases), oxygenation (two cases), cardiac monitoring (one case), intravenous lines (eight cases), airway (two cases), ventilation (one case), equipment and personnel accompanying the patient (one case), bladder catheterization (four cases), nasogastric suctioning (one case), radiographs (nine cases), and spinal immobilization (seven cases). ⋯ A review of the literature shows that inadequacies in stabilization for transfer are widespread. This may be improved through physician education, use of transport teams, and judicious use of interhospital transport. The indications and responsibilities of transfer are discussed.