Pain management in the emergency department: a clinical review

Motov, Sergey; Vlasica, Katherine; Middlebrook, Igor; LaPietra, Alexis

doi:10.15441/ceem.21.161

Cited by 10 publications

(4 citation statements)

References 82 publications

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“…La población reportada son adultos jóvenes, siendo en total 201 pacientes menores de 60 años, estos registros son similares a los reportados en países europeos [19], esto podría explicar por qué la población estudiada presenta una baja prevalencia de enfermedades cardiovasculares; los AINES son los analgésicos más frecuentes para administración en el servicio, según expertos este tipo de analgésicos deberían usarse de primera línea especialmente en casos de dolor inflamatorio o musculoesquelético teniendo en cuenta las comorbilidades de los pacientes [20].…”

Section: Discussionunclassified

Caracterizacion y manejo de los pacientes que consultan por dolor agudo en un servicio de urgencias

Oliveros M.,

Duque,

Vanegas R.

2023

Rev. chil. anest.

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Objetivos: Describir las características de los pacientes que consultan por dolor agudo al servicio de urgencias y el manejo que se realiza en una institución de tercer nivel de la ciudad de Manizales. Material y Métodos: Análisis descriptivo con muestreo no probabilístico por conveniencia tomado de forma prospectiva de personas mayores de 18 años con dolor menor a 6 semanas de evolución, que consultaron a un servicio de urgencias entre noviembre de 2022 y enero de 2023. Resultados: Se recolecto un total de 254 de esos se excluyeron 15 pacientes para un total de 239 pacientes estudiados. El sexo predominante en la consulta fue el femenino con 62,8%, no se encontraron diferencias significativas en la severidad de la escala de ingreso de dolor entre hombres y mujeres. Del análisis de la prevalencia del origen de dolor el mayor número de ingresos se debió a eventos no traumáticos (n = 181; 75,7%), y en cuanto a la localización, el dolor abdominal es el más prevalente (n: 102; 42,7%). Conclusiones: La mayor prevalencia de dolor de origen no traumático, es una población joven, con pocas comorbilidades cardiovasculares. Los AINES son los analgésicos más utilizados independiente de la severidad del dolor al ingreso. Se registró una baja proporción de revaloraciones en cuanto a la efectividad del manejo analgésico

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Section: Discussionunclassified

Caracterizacion y manejo de los pacientes que consultan por dolor agudo en un servicio de urgencias

Oliveros M.,

Duque,

Vanegas R.

2023

Rev. chil. anest.

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“…Pharmaceutical opioids are prescribed for the treatment of moderate to severe acute and malignant pain [ 1 ]. These medications are a mainstay of emergency medical practice, playing an important role in providing pain relief to many people during an acute episode of care [ 2 ]. A multitude of opioids are available for administration through parenteral, transdermal and enteral routes.…”

Section: Introductionmentioning

confidence: 99%

Influences of Software Changes on Oxycodone Prescribing at an Australian Tertiary Emergency Department: A Retrospective Review

Barrington,

Davis,

Aandahl

et al. 2024

Pharmacy

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Opioid prescribing and dispensing from emergency departments is a noteworthy issue given widespread opioid misuse and diversion in many countries, contributing both physical and economic harm to the population. High patient numbers and the stochastic nature of acute emergency presentations to emergency departments (EDs) introduce challenges for prescribers who are considering opioid stewardship principles. This study investigated the effect of changes to electronic prescribing software on prescriptions with an auto-populated quantity of oxycodone immediate release (IR) from an Australian tertiary emergency department following the implementation of national recommendations for reduced pack sizes. A retrospective review of oxycodone IR prescriptions over two six-month periods between 2019 and 2021 was undertaken, either side of a software adjustment to reduce the default quantities of tablets prescribed from 20 to 10. Patient demographic details were collected, and prescriber years of practice calculated for inclusion in linear mixed effects regression modelling. A reduction in the median number of tablets prescribed per prescription following the software changes (13.5 to 10.0, p < 0.001) with little change in the underlying characteristics of the patient or prescriber populations was observed, as well as an 11.65% reduction in the total number of tablets prescribed. The prescriber’s years of practice, patient age and patient sex were found to influence increased prescription sizes. Reduced quantity of oxycodone tablets prescribed was achieved by alteration of prescribing software prefill parameters, providing further evidence to support systems-based policy interventions to influence health care providers behaviour and to act as a forcing function for prescribers to consider opioid stewardship principles.

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“…The use of pharmacological analgesia is associated with increased risks of addiction and tolerance (4,5). It has been suggested that multi-modal approaches that include nonpharmacological interventions are safe alternatives that can reduce over-reliance on pharmacological analgesia and its associated adverse effects (5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

The use and outcomes of non-pharmacological analgesia in the adult emergency department

Assiry,

Brown,

Hazelwood

et al. 2023

Preprint

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Background: The treatment of pain in the emergency department (ED) has historically relied on pharmacological analgesia. However, little is known about the concurrent use of non-pharmacological analgesia. Aims/Objectives: This research explores the self-reported use and outcomes of non-pharmacological analgesia in adult ED patients with moderate to severe pain. Methods: This is a cross-sectional study in an adult ED of self-reported use of non-pharmacological pain management via a patient-reported outcome measure. The results are presented with descriptive statistics and multivariable modelling. Results: 45.8% (n=296) of all respondents used non-pharmacological interventions. The most used non-pharmacological interventions are hot packs (34.9%, n=103), distraction (22.3%, n=66), and cold packs (12.9%, n=38). In multivariate modelling, females, patients who did not receive pre-hospital analgesia, and daily average access block time all affected the use of non-pharmacological analgesia. Within a multivariable model, non-pharmacological analgesia increased the amount of pain relief achieved. Conclusion: Non-pharmacological analgesia use is affected by gender, treatment before the ED and ED workload. Nevertheless, clear benefits to the use of non-pharmacological analgesia were seen. Further work must be undertaken to encourage providers' use of this modality and capture any additional benefits to the patient.

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Pain management in the emergency department: a clinical review

Cited by 10 publications

References 82 publications

Caracterizacion y manejo de los pacientes que consultan por dolor agudo en un servicio de urgencias

Caracterizacion y manejo de los pacientes que consultan por dolor agudo en un servicio de urgencias

Influences of Software Changes on Oxycodone Prescribing at an Australian Tertiary Emergency Department: A Retrospective Review

The use and outcomes of non-pharmacological analgesia in the adult emergency department

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