scholarly journals Musculoskeletal pain management in the Emergency Department

2020 ◽  
Vol 6 (1) ◽  
pp. 36
Author(s):  
Kyriaki Seremeti ◽  
George Vasilopoulos ◽  
Georgia Toylia ◽  
Olga Kadda ◽  
Evangelia Kourousi ◽  
...  

Introduction: The intensity of acute musculoskeletal pain is underestimated by health providers. Analgesia in adults that receive treatment for acute musculoskeletal pain varies from 11-29%. The timely and effective treatment of pain should become priority for the adequate pain management.Aim: The aim of the present study was to explore musculoskeletal pain management in the emergency department (ED).Material and Method: This is a descriptive study. The studied sample consisted of 82 patients, who admitted in the ED of Athen’s general hospital, due to acute musculoskeletal pain. For data collection, a special designed registration form was used. Related measurements were completed at two time points; the first time point was during patients’ admission to ED and the second one, 30 minutes post treatment or post ED discharge.Results: Patients average pain score was 7.25 ± 1.85 (first time point) and 3.76 ± 2.66 (second time point). Analgesia was provided to 51.2% of the sample and non-invasive methods were used in 51.2%. As for the frequency of the administrated drugs, analgesics were mostly preferred (29.3%), nonsteroidal anti-inflammatory drugs (NSAIDs) at 25.6% and opioids were used only at 9.8%. The mean time to first anministrated analgesic therapy was 16.56 ± 32.89 min.Conclusions: In spite of the extensive research and international guidelines for pain management, the fulfillment of the patients’ expectations for adequate and timely relief remains a challenge. The key for successful pain management lies to further education of medical stuff. 

2020 ◽  
Author(s):  
Kyriaki Seremeti ◽  
Georgios Vasilopoulos ◽  
Georgia Toylia ◽  
Olga Kadda ◽  
Evangelia Kourousi ◽  
...  

Abstract Introduction: The intensity of acute musculoskeletal pain is underestimated by health providers. Analgesia in adults that receive treatment for acute musculoskeletal pain varies from 11-29%. The timely and effective treatment of pain should become priority for the adequate pain management.Aim: The aim of the present study was to explore musculoskeletal pain management in the emergency department (ED).Material and Method: This is a descriptive study. The studied sample consisted of 82 patients, who admitted in the ED of Athen’s general hospital, due to acute musculoskeletal pain. For data collection, a special designed registration form was used. Related measurements were completed at two time points; the first time point was during patients’ admission to ED and the second one, 30 minutes post treatment or post ED discharge.Results: Patients average pain score was 7.25 ± 1.85 (first time point) and 3.76 ± 2.66 (second time point). Analgesia was provided to 51.2% of the sample and non-invasive methods were used in 51.2%. As for the frequency of the administrated drugs, analgesics were mostly preferred (29.3%), nonsteroidal anti-inflammatory drugs (NSAIDs) at 25.6% and opioids were used only at 9.8%. The mean time to first anministrated analgesic therapy was 16.56 ± 32.89 min.Conclusions: In spite of the extensive research and international guidelines for pain management, the fulfillment of the patients’ expectations for adequate and timely relief remains a challenge. The key for successful pain management lies to further education of medical stuff.


2021 ◽  
Vol 8 (4) ◽  
pp. 268-278
Author(s):  
Sergey M. Motov ◽  
Katherine Vlasica ◽  
Igor Middlebrook ◽  
Alexis LaPietra

Pain is one of the most common reasons for patients to visit the emergency department. The ever-growing research on emergency department analgesia has challenged the current practices with respect to the optimal analgesic regimen for acute musculoskeletal pain, safe and judicious opioid prescribing, appropriate utilization of non-opioid therapeutics, and non-pharmacological treatment modalities. This clinical review is set to provide evidence-based answers to these challenging questions.


Trauma ◽  
2018 ◽  
Vol 21 (2) ◽  
pp. 107-112 ◽  
Author(s):  
Mehdi Torabi ◽  
Ali Mehri ◽  
Moghaddameh Mirzaei

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.


2013 ◽  
Vol 32 (2) ◽  
pp. 149-152 ◽  
Author(s):  
Ofir Uri ◽  
Shlomo Elias ◽  
Eyal Behrbalk ◽  
Pinchas Halpern

2020 ◽  
Vol 8 (1) ◽  
pp. 21-21
Author(s):  
Mani Mofidi ◽  
Ali Dashti ◽  
Mahdi Rezai ◽  
Niloufar Ghodrati ◽  
Hoorolnesa Ameli ◽  
...  

Introduction: This study was designed to compare the effectiveness of intravenous morphine with nebulized morphine in pain relief of patients referring to the emergency setting with traumatic musculoskeletal pain. Methods: This randomized, placebo-controlled and double-blind clinical study evaluated 160 patients 18 to 65 years of age with acute traumatic pain, who attended the emergency department during 2019. Subjects were assessed with Numerical Rating Scale based on inclusion and exclusion criteria and randomly divided into two groups. In one group, 80 patients received IV morphine (0.1 mg/kg+5 mL normal saline) plus an equivalent volume of IV placebo. In the second group, 80 patients received nebulized morphine (0.2 mg/kg+5 mL normal saline) plus nebulized placebo. Pain score was monitored in all patients with Numerical Rating Scale before and after intervention at baseline, 15, 30, 45, and 60-minute intervals. Patients’ vital signs and possible adverse events were evaluated in each observation time points. Finally, all participants were assessed for their satisfaction with pain management. Data were analyzed using repeated measure analysis for continuous variables and Binomial test for categorical variables Results: There was no significant difference between the demographic characteristics of patients in study groups. Pain relief between the two groups was similar during the observation (0, 15, 30, 45, 60 min) (P>0.05). There were no changes in vital signs between two groups, although the nebulized group had lower systolic blood pressure at the time-point of 15 minutes after the treatment initiation (P=0.03). Conclusion: Although Nebulized morphine has similar efficacy in comparison with IV route, nebulization might be considered as the clinically efficacious route of morphine administration with minimal side effects, providing optimal pain relief in patients.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Paul Owono Etoundi ◽  
Junette Arlette Metogo Mbengono ◽  
Ferdinand Ndom Ntock ◽  
Joel Noutakdie Tochie ◽  
Dominique Christelle Anaba Ndom ◽  
...  

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lan N. Truong ◽  
Brayden D. Whitlock

AbstractControlling infections has become one of the biggest problems in the world, whether measured in lives lost or money spent. This is worsening as pathogens continue becoming resistant to therapeutics. Antimicrobial surfaces are one strategy being investigated in an attempt to decrease the spread of infections through the most common route of transmission: surfaces, including hands. Regulators have chosen two hours as the time point at which efficacy should be measured. The objectives of this study were to characterize the new antimicrobial surface compressed sodium chloride (CSC) so that its action may be understood at timepoints more relevant to real-time infection control, under two minutes; to develop a sensitive method to test efficacy at short time points; and to investigate antifungal properties for the first time. E. coli and Candida auris are added to surfaces, and the surfaces are monitored by contact plate, or by washing into collection vats. An improved method of testing antimicrobial efficacy is reported. Antimicrobial CSC achieves at least 99.9% reduction of E. coli in the first two minutes of contact, and at least 99% reduction of C. auris in one minute.


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