Pain management in the emergency service

Pain management in the emergency
service
The treatment of pain can be approached from different points within its physiopathology by Nj
Arthritis Doctor. It is important that the trafficker knows where and how the medicines that he
prescribes act, to try to make a multimodal approach to pain management and to avoid the
adverse effects and contraindications of them. This means that if, for example, a patient presents
to the ED with pain 8/10 originating from a typical lumbar pain syndrome, the patient will
require, if desired, intravenous analgesia and more than one medication. This combination of
drugs must attack different pathways of pain, combining for example non-steroidal antiinflammatory analgesics (NSAIDs), opioids and paracetamol. The treatment of this patient
should in no case combine 2 NSAIDs as this would only increase the risks of adverse effects,
without improving the analgesic effects of the drugs you are using. Also, the trafficker should try
to obtain synergistic effects of the drugs he uses, such as in the combination of acetaminophen
with opioids.
A high impact intervention for the correct use of these medications has been the incorporation of
clinical pharmacologists within the emergency personnel. These Nj Pain Management, supervise
and follow up the prescriptions, both in the emergency unit and the discharge instructions.
Among its functions are to cooperate with the team performing pharmacokinetic analysis of
special patients to adjust their doses or determine the presence of problems associated with
medication such as cross allergies, drug interactions, contraindications, among others. Finally,
they record the errors of prescription and administration technique. It has been shown that all
these interventions can reduce the errors of general medication, up to 80%.
Things to consider while taking pain treatment
Another important point of Clifton Pain Management is the relief of concomitant symptoms
such as anxiety, nausea and dyspnea, since without the management of pain; the relief of the
patient's suffering will not be obtained. There are numerous drugs recommended by Pain
Management Doctors Nj that can be associated with analgesics for the management of these as
benzodiazepines, antiemetics, antispasmodics, as well as the use of other techniques, for example,
use of non-invasive mechanical ventilation, in the most extreme cases.
In the group of pediatric patients, we must have a comprehensive management policy for this
problem and transform the emergency services into "Units without pain". The attention of
children who consult for acute pain or those who require analgesia for painful procedures,
presents a great challenge, since it generates stress in patients, relatives and health team. Sub
optimal analgesia is unacceptable in this group of patients. For example, in a study of the PERC
group in children with suspected acute appendicitis, the average " triage to analgesia " time was
200 minutes, more than 40% of the analgesia administrations were performed after the surgeon's
evaluation and in addition, over 40% of children received analgesia after abdominal ultrasound,
with the obvious associated discomfort 15 . Later it will be explained, that removing pain early,
does not impede, but on the contrary, improves the diagnostic process.
It is interesting to highlight two novel strategies for a standardized comprehensive management
with the purpose of projecting itself as an emergency service "without pain for children".