Fentanyl trauma analgesia use in air medical scene transports

Thomas, Stephen; Rago, Oscar; Harrison, Tim; Biddinger, Paul D.; Wedel, Suzanne K.

doi:10.1016/j.jemermed.2005.02.007

Cited by 35 publications

(36 citation statements)

References 31 publications

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“…Five studies evaluated analgesic efficacy [11][12][13][14][15]. Efficacy was defined as a measurable reduction in pain upon the administration of analgesics.…”

Section: Efficacymentioning

confidence: 99%

Prehospital pain management of injured children: a systematic review of current evidence

Samuel

Steiner

Shavit

2015

The American Journal of Emergency Medicine

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“…Five studies evaluated analgesic efficacy [11][12][13][14][15]. Efficacy was defined as a measurable reduction in pain upon the administration of analgesics.…”

Section: Efficacymentioning

confidence: 99%

Prehospital pain management of injured children: a systematic review of current evidence

Samuel

Steiner

Shavit

2015

The American Journal of Emergency Medicine

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“…This difference also remained statistically significant after limiting the analyses to only the 71 cases where intra-nasal fentanyl was used in first intention. Sixteen fascia iliaca compartment blocks were performed by 6 different physicians for 13 femoral shaft and 3 [7]. Table 3: Delays according to analgesia provision.…”

Section: Co-treatmentsmentioning

confidence: 99%

“…Non-pharmacological measures were not systematically documented by physicians in this study (reassurance, splinting, reduction of a joint dislocation, fracture realignment, etc.) although their role in pain management is essential [1,7], even if they impact the time spent at the scene. This limitation, however, is applicable to every patient in the study.…”

Section: Limitationsmentioning

confidence: 99%

Pain Management Strategies and Time Spent on Scene for Pre-Hospital Analgesia Provision in an Alpine Environment: A Retrospective Study

Pasquier¹,

Eidenbenz²,

Dami³

et al. 2017

Emerg Med

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Objective: The delivery of a safe an effective analgesia is a core principle and a priority of prehospital care. Analgesia in hostile environments (mountain settings, etc.) presents various challenges, and the benefit-risk ratio of the procedure should be evaluated. The objective of this study was to examine pain management strategies and the time spent on scene for analgesia provisions in an alpine environment. Methods:We undertook a retrospective study from a single physician-staffed helicopter emergency medical service in the Swiss Alps. Patients with isolated limb injuries were included. We examined the choice and route of analgesic medication, patient monitoring, medical co-treatments and time delays during the rescue mission.Results: Analgesia was provided to 657 (57%) of the 1156 included patients. Fentanyl was most commonly administered followed by ketamine, with or without fentanyl. Heart rhythm monitoring, oxygen administration, and saline infusion were used infrequently, but were used significantly more often in patients treated with ketamine. The median time on site was 6 minutes longer for patients receiving intravenous analgesia compared with those not receiving it.Conclusion: Analgesia in hostile environments seems to be limited to essential procedures. The safety of this approach must be confirmed.

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“…Its introduction into common ED use (in the United States, at least) was probably based more on use for procedural sedation or rapid sequence intubation rather than isolated analgesia, but ED physicians have been familiar with the agent for many decades [193,194]. Over the years, IV fentanyl has been demonstrated safe and effective for a breadth of conditions in acute care [25,26,[195][196][197]. Data support the idea that, while appropriately dosed morphine and fentanyl should have roughly equal analgesic effects, fentanyl has a significantly faster onset time [198].…”

Section: Fentanylmentioning

confidence: 99%

“…The problem is not so much one of diagnostic clouding by analgesics (although this is sometimes an issue), as it is the risking of physiologic compromise from opioids [229]. Concerns for respiratory and hemodynamic depression from analgesics are often bruited as rationale for withholding of trauma analgesia, but trauma analgesia can be safely improved and provided with educational programs that incorporate emphasis on judicious medication use [3,25,196,[230][231][232][233].…”

Section: Special Issues Withmentioning

confidence: 99%

Management of Pain in the Emergency Department

Thomas

2013

ISRN Emergency Medicine

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Since pain is a primary impetus for patient presentation to the Emergency Department (ED), its treatment should be a priority for acute care providers. Historically, the ED has been marked by shortcomings in both the evaluation and amelioration of pain. Over the past decade, improvements in the science of pain assessment and management have combined to facilitate care improvements in the ED. The purpose of this review is to address selected topics within the realm of ED pain management. Commencing with general principles and definitions, the review continues with an assessment of areas of controversy and advancing knowledge in acute pain care. Some barriers to optimal pain care are discussed, and potential mechanisms to overcome these barriers are offered. While the review is not intended as a resource for specific pain conditions or drug information, selected agents and approaches are mentioned with respect to evolving evidence and areas for future research.

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Fentanyl trauma analgesia use in air medical scene transports

Cited by 35 publications

References 31 publications

Prehospital pain management of injured children: a systematic review of current evidence

Prehospital pain management of injured children: a systematic review of current evidence

Pain Management Strategies and Time Spent on Scene for Pre-Hospital Analgesia Provision in an Alpine Environment: A Retrospective Study

Management of Pain in the Emergency Department

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