scholarly journals Introduction of a paediatric pain management protocol improves assessment and management of pain in children in the emergency department

2007 ◽  
Vol 92 (9) ◽  
pp. 828-829 ◽  
Author(s):  
S Eisen ◽  
K Amiel
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Management Protocol

scholarly journals Assessment of the implementation of a nurse-initiated pain management protocol in the emergency department

2021 ◽  
Vol 74 (3) ◽  
Author(s):  
Marcia Boessio dos Santos ◽  
Cristiana Maria Toscano ◽  
Ruth Ester Assayag Batista ◽  
Elena Bohomol
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Pain Management ◽  
Intervention Group ◽  
Pain Medication ◽  
Pain Level ◽  
Protocol Adherence ◽  
Management Protocol ◽  
Emergency Department Patients ◽  
Analgesic Administration

ABSTRACT Objectives: to assess the implementation of a nurse-initiated pain management protocol for patients triaged as semi-urgent, and its impact in pain intensity, in the Emergency Department. Methods: a prospective cohort study for adult patients with pain who had been triaged as semi-urgent and admitted to the hospital’s Emergency Department. Patients who received the intervention (pain-management protocol with analgesic administration) were compared to those who were managed using the conventional approach (physician evaluation prior to analgesic administration). Results: of the 185 patients included, 55 (30%) received the intervention, and 130 (70%) were managed conventionally. Patients in the intervention group were more likely to have taken pain medication in the 4 hours prior to admission, and reported higher levels of pain at admission and more significant reductions in pain level. Conclusions: despite low protocol adherence, the intervention resulted in higher reported pain relief.

The effect of pain management in reducing limb and spine radiography in stable traumatic patients admitted to the emergency department

Trauma ◽  
2018 ◽  
Vol 21 (2) ◽  
pp. 107-112 ◽  
Author(s):  
Mehdi Torabi ◽  
Ali Mehri ◽  
Moghaddameh Mirzaei
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Pain Management ◽  
Musculoskeletal Pain ◽  
Hospital Costs ◽  
Primary Outcome Measure ◽  
Lower Limbs ◽  
Trauma Patients ◽  
X Rays ◽  
Management Protocol

Introduction Musculoskeletal pain caused by trauma is one of the common complaints of patients referred to the emergency department. Due to the lack of a proper pain control protocol, doctors and nurses do not pay attention to pain, and physicians may tend to request too many radiographs, many of which will be unnecessary. We aimed to study the effect of pain management by fentanyl in reducing the number of radiographs, reducing hospital costs and increasing satisfaction in the patients on patients with isolated trauma in limbs and spine causing musculoskeletal pain. Patients and methods A cohort of patients who were referred to the fast-track emergency department with isolated trauma of the upper and lower limbs or spine and triage levels 3, 4 and 5, were visited twice by an emergency medicine resident – before and after application of a pain management protocol using intravenous fentanyl as the principle analgesic. The primary outcome measure was the reduction in the number of radiographs requested; secondary outcomes included alterations in pain levels and patient satisfaction. Results A total of 158 patients were included in the study. The median age was 27.5 years, three quarters were male and 20.88% had a positive history of opium addiction. The number and costs of diagnostic radiography significantly decreased after the administration of fentanyl (P < 0.0001), as did pain levels measured on visual analogue scale with a consequent increase in patient satisfaction. There were only six complications resulting from fentanyl administration which were mild and transient. Follow-up after 24–72 h, revealed no missed fractures. Conclusions The administration of fentanyl as a strong analgesic as part of an emergency department pain management protocol for trauma patients can be performed with limited minor complications; it can reduce the number of unnecessary X-rays performed, exposure to ionizing radiation and hospital costs as well as improving patient satisfaction without missing fractures.

scholarly journals P126: Analysis of acute pain management in the emergency department of a large private hospital in Cape Town, South Africa

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S120-S120
Author(s):  
M. Stander
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Acute Pain ◽  
Descriptive Analysis ◽  
Acute Pain Management ◽  
Convenience Sample ◽  
Pain Scores ◽  
Triage Category ◽  
Management Protocol ◽  
Depth Analysis

Introduction: Pain is a common presenting complaint amongst emergency department (ED) patients. Evidence suggests that pain is often inadequately and inconsistently treated resulting in oligoanalgesia. Patients that do not have their pain timeously recognised and treated end up with an inferior patient experience in the ED. It was speculated that pain management in Panorama Mediclinic ED was not optimal and an in-depth analysis of pain management trends was performed in order to lead to a targeted intervention which would result in better care in the ED. Methods: A convenience sample of 100 random folders was collected from May-July 2015. Folders with presenting complaints excluding pain and children under 10 years of age were excluded. The data were collected onto a password protected Excel database and analysed using basic descriptive analysis. Results: 44% of patients included were green triage category, 30% yellow, 23% orange and 1% red. 82% of patients presented with verbal pain scores greater than 5/10. The average time to receive analgesia was 60.26 minutes. 33.3% of patients only received analgesia after being in the ED for >60 minutes. Of those patients receiving delayed analgesia, the majority of their pain scores were between 6-8/10. Abdominal and extremity pain together consisted of 51% of the anatomical pain distribution. 29% of the patients sampled received no analgesia during their visit to the EC and the majority of their pain scores were between 3-6/10. Intravenous acetaminophen, intravenous opioids and intramuscular opioids are by far the most common pharmaceutical agents to treat acute pain in this ED. Conclusion: This study demonstrated that acute pain is not well managed in the ED of Panorama Mediclinic. Subsequently an acute pain management protocol was implemented in which all patients with pain scores greater than 5/10 are offered early analgesia on initial presentation to the ED by the triage nurse.

Observational, Retrospective Evaluation of a New Nurse-Initiated Emergency Department Pain Management Protocol

2021 ◽  
Author(s):  
Coline Muscat ◽  
Stéphanie Fey ◽  
Magalie Lacan ◽  
Claire Morvan ◽  
Loïc Belle ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Retrospective Evaluation ◽  
Management Protocol

The influence of continuous local wound infusion on postoperative pain in patients undergoing transfemoral amputation

VASA ◽  
2015 ◽  
Vol 44 (5) ◽  
pp. 381-386 ◽  
Author(s):  
Christian Uhl ◽  
Thomas Betz ◽  
Andrea Rupp ◽  
Markus Steinbauer ◽  
Ingolf Töpel
Keyword(s):  
Pain Management ◽  
Pilot Study ◽  
Local Anaesthetic ◽  
Phantom Pain ◽  
Transfemoral Amputation ◽  
Postoperative Wound ◽  
Stump Pain ◽  
Management Protocol ◽  
Group 2 ◽  
Group 1

Abstract. Summary: Background: This pilot study was set up to examine the effects of a continuous postoperative wound infusion system with a local anaesthetic on perioperative pain and the consumption of analgesics. Patients and methods: We included 42 patients in this prospective observational pilot study. Patients were divided into two groups. One group was treated in accordance with the WHO standard pain management protocol and in addition to that received a continuous local wound infusion treatment (Group 1). Group 2 was treated with analgesics in accordance with the WHO standard pain management protocol, exclusively. Results: The study demonstrated a significantly reduced postoperative VAS score for stump pain in Group 1 for the first 5 days. Furthermore, the intake of opiates was significantly reduced in Group 1 (day 1, Group 1: 42.1 vs. Group 2: 73.5, p = 0.010; day 2, Group 1: 27.7 vs. Group 2: 52.5, p = 0.012; day 3, Group 1: 23.9 vs. Group 2: 53.5, p = 0.002; day 4, Group 1: 15.7 vs. Group 2: 48.3, p = 0.003; day 5, Group 1 13.3 vs. Group 2: 49.9, p = 0.001). There were no significant differences between the two groups, neither in phantom pain intensity at discharge nor postoperative complications and death. Conclusions: Continuous postoperative wound infusion with a local anaesthetic in combination with a standard pain management protocol can reduce both stump pain and opiate intake in patients who have undergone transfemoral amputation. Phantom pain was not significantly affected.

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