Articles: acute-pain.
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Sexual assault (SA) is common, but the epidemiology of acute pain after SA has not previously been reported. We evaluated the severity and distribution of pain symptoms in the early aftermath of SA among women receiving Sexual Assault Nurse Examiner (SANE) care, and the treatment of pain by SANE nurses. Severe pain (≥7 on a 0-10 numeric rating scale) was reported by 53/83 women sexual assault survivors (64% [95% CI, 53-74%]) at the time of SANE evaluation and 43/83 women (52% [95% CI, 41-63%]) 1 week later. Pain in 4 or more body regions was reported by 44/83 women (53% [95% CI, 42-64%]) at the time of initial evaluation and 49/83 women (59% [95% CI, 48-70%]) at 1 week follow-up. Among survivors with severe pain at the time of initial postassault evaluation, only 7/53 (13% [95% CI, 6-26%]) received any pain medication at the time of initial SANE treatment. These findings suggest that pain is common in SA survivors in the early postassault period, but rarely treated. ⋯ Acute pain is common after sexual assault. Practice guidelines for SANE nurses and others who provide care to sexual assault survivors in the early aftermath of assault should include specific recommendations for pain evaluation and treatment. Prospective longitudinal studies of pain outcomes among sexual assault survivors are needed.
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Randomized Controlled Trial
Virtual reality for acute pain reduction in adolescents undergoing burn wound care: a prospective randomized controlled trial.
Effective pain management remains a challenge for adolescents during conscious burn wound care procedures. Virtual reality (VR) shows promise as a non-pharmacological adjunct in reducing pain. ⋯ Despite only minimal pain reduction achieved using off-the-shelf VR, other results from this trial and previous research on younger children with burns suggest a customized, adolescent and hospital friendly device may be more effective in pain reduction.
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An exploratory study was undertaken to examine how being denied prescription opioids to treat pain impacted the drug-using careers of young adults with a history of misuse of prescription drugs. ⋯ Being denied prescription opioids was an important moment in the drug using careers of many study participants. Results suggest that effective pain management techniques are needed to prevent high-risk young adults with pain problems from engaging in escalated opioid misuse and risk behaviors.
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Interact Cardiovasc Thorac Surg · Aug 2012
Case ReportsAn unusual cause of acute abdominal pain after cardiac surgery: acute epiploic appendagitis.
Abdominal complications following cardiac surgery remain unusual, but are associated with high mortality. The most common abdominal surgical complications are mesenteric ischaemia, diverticulitis, pancreatitis, gastrointestinal bleeding and cholecystitis. We describe a case of a 73-year old woman with acute abdominal pain mimicking cholecystitis on day 10 after aortic valve replacement. ⋯ Depending on its localization, it mimics many diagnoses requiring surgery: colitis, diverticulitis, appendicitis and cholecystitis. An abdominal CT scan is the diagnostic imaging tool of choice. All physicians involved in post-cardiac surgery care should be aware of this self-limiting disease that usually resolves with non-steroidal anti-inflammatory drugs and watchful waiting, and to avoid unnecessary surgery because the spontaneous evolution of epiploic appendagitis is usually benign.
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Systems for and methods of quality management are increasingly being implemented in public health services. The aim of our study was to analyze the current state of the integrated quality management concept "quality management acute pain therapy" of the TÜV Rheinland® (TÜV) after a 5-year project period. ⋯ Certification by the TÜV leads to sustainable implementation of quality management principles. Future efforts should focus on better integration of physicians in acute pain therapy and the development of an integrated tool to measure patients' outcome.