Pain medicine : the official journal of the American Academy of Pain Medicine
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Patients who experience their nonmalignant chronic pain as intolerable sometimes present at Emergency Departments (EDs). However, as emergency medical services are set up to provide rapid treatment for acute injury or illness; there is potential for misunderstanding and disappointment. Literature on the topic of ED staff attitudes toward chronic pain patients is minimal, USA-based and methodologically unsatisfying. We carried out an in-depth, qualitative study identifying the attitudes and narratives of ED staff around people in chronic pain. ⋯ ED staff found people presenting at ED with chronic pain to be a challenging and frustrating population to treat. Staff was constrained by the fast-paced nature of their jobs as well as the need to prioritise emergency cases, and so were unable to spend the time needed by chronic pain patients. This was seen as being bad for staff, and for the patient experience. Staff suggested that care could be improved by appropriate information, signposting and with time invested in communication with the patient.
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Anesthesiologists performing peripheral nerve blocks under ultrasound guidance look frequently back and forth between the patient and the ultrasound screen during the procedure. These head movements add time and complexity to the procedure. The head-mounted display (HMD) device is a commercially available head-mounted video display that is connected to the ultrasound machine and projects the ultrasound image onto the HMD glasses, enabling the anesthesiologist to monitor the screen without ever needing to look away from the patient. We hypothesized that the use of the HMD device would decrease the total procedure time as well as operator head and ultrasound probe movements during a simulated nerve block. ⋯ Use of a HMD improved efficiency and human factors during simulated nerve blocks. This suggests that a clinical study to see if this observation translates into a clinical setting is warranted.