Author: Gavin Lloyd / Editors: Steve Fordham, Jon Jones / Reviewer: David Leverton, Gavin Lloyd / Code: CC2, CC3 / Published: 15/07/2023
In this session you will cover the pathophysiology of pain, the use of pain assessment tools and typical analgesic agents used in the Emergency Department (ED). The session also proposes appropriate strategies for addressing patients pain and how to modify these for special patient groups.
After completing this session you will be able to:
- Describe the pathophysiology of pain
- Use a variety of pain assessment tools
- Contrast the properties of typical analgesic agents used in emergency medicine
- Propose appropriate strategies for addressing patients’ pain
- Modify the analgesia treatment plan for special patient groups
References
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- Gallagher EJ, Liebman M, Bijur PE. Prospective validation of clinically important changes in pain severity measured on a visual analog scale. Ann Emerg Med. 2001 Dec;38(6):633-8.
- Jadav MA, Lloyd G, McLauchlan C, Hayes C. Routine pain scoring does not improve analgesia provision for children in the emergency department. Emerg Med J. 2009 Oct;26(10):695-7.
- Kendall J M, Reeves B C, Latter V S. Multicentre randomised controlled trial of nasal diamorphine for analgesia in children and teenagers with clinical fractures. BMJ 2001; 322 :261
- Acute Pain Management: Scientific Evidence. Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine, 2020.
- Bradshaw M, Sen A. Use of a prophylactic antiemetic with morphine in acute pain: randomised controlled trial. Emerg Med J. 2006 Mar;23(3):210-3.
- Carley S. IVRA (Biers block) is better than haematoma block for manipulating Colles’ fractures. BestBets, 2000. Updated: 2005.
- Fletcher AK, Rigby AS, Heyes FL. Three-in-one femoral nerve block as analgesia for fractured neck of femur in the emergency department: a randomized, controlled trial. Ann Emerg Med. 2003 Feb;41(2):227-33.
- Blau LA, Hoehns JD. Analgesic efficacy of calcitonin for vertebral fracture pain. Ann Pharmacother. 2003 Apr;37(4):564-70.
- Gibler WB, Cannon CP, Blomkalns AL, Char DM, et al. Practical implementation of the guidelines for unstable angina/non-ST-segment elevation myocardial infarction in the emergency department: a scientific statement from the American Heart Association Council on Clinical Cardiology (Subcommittee on Acute Cardiac Care), Council on Cardiovascular Nursing, and Quality of Care and Outcomes Research Interdisciplinary Working Group, in Collaboration With the Society of Chest Pain Centers. Circulation. 2005 May 24;111(20):2699-710..
- Pollack CV, Antman EM, Hollander JE. 2007 Focused Update to the ACC/AHA Guidelines for the Management of Patients With ST-Segment Elevation Myocardial Infarction: Implications for Emergency Department Practice. Annals of Emergency Medicine, 2008; 52:344-355.e1.
- Baumann BM, Perrone J, et al. Randomized, double-blind, placebo-controlled trial of diazepam, nitroglycerin, or both for treatment of patients with potential cocaine-associated acute coronary syndromes. Acad Emerg Med. 2000 Aug;7(8):878-85.
- Manterola C, Astudillo P, et al. Analgesia in patients with acute abdominal pain. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD005660.
- McHale PM, LoVecchio F. Narcotic analgesia in the acute abdomen–a review of prospective trials. Eur J Emerg Med. 2001 Jun;8(2):131-6.
- Holdgate A, Pollock T. Systematic review of the relative efficacy of non-steroidal anti-inflammatory drugs and opioids in the treatment of acute renal colic. BMJ 2004; 328 :1401
- Marjoribanks J, Proctor ML, Farquhar C. Nonsteroidal anti-inflammatory drugs for primary dysmenorrhoea. Cochrane Database Syst Rev. 2003;(4):CD001751. doi: 10.1002/14651858.CD001751. Update in: Cochrane Database Syst Rev. 2010;(1):CD001751.
