scholarly journals Assessment of the effectiveness of pain management among trauma patients in the emergency department

2020 ◽  
Author(s):  
Ahmad Wazzan ◽  
Yazeed Khalid Albeladi ◽  
Rozan Ibrahim Altaifi ◽  
Mohammed Saeed Alqahtani ◽  
Rayan Mahmoud Bakheet
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Pain Scale ◽  
Initial Assessment ◽  
P Value ◽  
Time Of Arrival ◽  
Trauma Patients ◽  
Pain Scores ◽  
Before And After ◽  
Numeric Pain Scale

Abstract Background:In the emergency department (ED), pain is the most common complaint, especially among trauma patients. However, two-thirds of trauma patients are discharged from EDs with moderate to severe pain. Therefore, pain management is an important part of care in ED's trauma patients.Aim:To assess the effectiveness of pain management among trauma patients in the ED.Method:A retrospective cohort study that was conducted on adult trauma patients who attended the ED at King Abdulaziz medical city (KAMC) in Jeddah from the period (June 2016 to July 2018). The pain was measured twice, one before the intervention and one after intervention using a numeric pain scale. Data were collected from health information system (Best care®) and analyzed using SPSS version 24.Results:The Mean difference between pain scores before and after pain management was one on a numeric pain scale with a P-Value 0.001. Initial pain assessment occurred only in 69% of our population, while assessment after intervention happened in 71% of patients. Patients who received appropriate medication were 36.7%. 35% of patients received opioids as an initial drug of pain management; only 8.8% of patients had pain scores more than 7 initially. The median between the time of arrival and the time of Initial Assessment is 19 mins.Conclusion:Pain management in ED needs improvement. Timeliness of pain management should be addressed. Evaluation and re-evaluation of pain before and after the intervention is insufficient. Trauma Patients don't receive effective pain management in the ED.

The relationship between QT interval and pain severity in trauma patients in the emergency department

2021 ◽  
pp. 75-78
Keyword(s):  
Emergency Department ◽  
Qt Interval ◽  
Statistical Significance ◽  
Severe Trauma ◽  
Pain Severity ◽  
Control Group ◽  
P Value ◽  
Trauma Patients ◽  
Before And After ◽  
The Relationship

Aim: Cardiac depolarization occurs in patients experiencing pain from acute traumas, and changes in QT interval could indicate the state of ventricular depolarization. Thus, we aimed to determine the relationship between pain severity and QT interval in patients experiencing acute trauma. Material and Method: Seventy patients, who were conscutively- admitted to the Emergency Department due to moderate or severe trauma (study group), and sixty healthy individuals (control group) were included in this study. The QT interval was calculated for each group before and after analgesia and visual analog scale pain levels were recorded. Statistical analyses were performed using SPSS for Windows software (ver. 21.0; SPSS Inc., Chicago, IL, USA). Data are presented as medians±interquartile range (IQR). Statistical significance was determined using Mann-Whitney U, Wilcoxon, and chi-square tests, with a p-value <0.05 considered significant. Results: The mean age of patients with trauma and control patients was 31.50±25 years and 35.00±20 years, respectively. Among trauma patients, QT, RR and corrected QT (QTc) intervals were significantly different before and after analgesia (P<0.001). Similarly, the average pre-analgesia QT, RR and QTc values also differed between pre- and post-analgesia trauma patients (p=0.007, p<0.001, and p<0.001, respectively). However, no differences in QT values were observed before and after analgesia between patients experiencing moderate versus severe pain (p>0.05). Conclusion: In trauma patients, acute pain prolonged the QT interval, which reverted to normal following the administration of nonsteroidal anti-inflammatory drugs. However, additional comparative studies on this topic are required.

scholarly journals SIKAP DAN PENGETAHUAN PERAWAT BERHUBUNGAN DENGAN PELAKSANAAN TRIAGE

2018 ◽  
Vol 9 (02) ◽  
pp. 154
Author(s):  
Dewi Ratna Sari ◽  
Sutanta .
Keyword(s):  
Emergency Department ◽  
Clinical Decision Making ◽  
Initial Assessment ◽  
Rank Test ◽  
P Value ◽  
Hospital Emergency Department ◽  
Hospital Emergency ◽  
Cross Sectional ◽  
Spearman Rank ◽  
Emergency Units

ABSTRAKPerawat yang bekerja di unit gawat darurat (UGD) harus memiliki sikap, ketrampilan dan kemampuan untuk mengatur kemampuan fungsional dalam berbagai kondisi. Perawat harus mampu memprioritaskan perawatan pasien atas dasar pengambilan keputusan klinis dimana keterampilan penting bagi perawat dalam penilaian awal. Untuk mendukung hal tersebut diperlukan pengetahuan, sikap dan ketrampilan dalam hal pemisahan jenis dan kegawatan pasien dalam triage, sehingga dalam penanganan pasien bisa lebih optimal dan terarah. Tujuan penelitian untuk mengetahui hubungan sikap dan pengetahuan perawat dalam pelaksanaan triage di UGD RSUD Wonosari. Penelitian ini menggunakan survei analitik korelasi dengan pendekatan cross sectional. Populasi penelitian berjumlah 15 perawat yang bekerja di ruang gawat darurat, dengan metode pengambilan sampel secara total sampling. Instrumen penelitian berupa kuisioner, metode analisa data menggunakan uji spearman rank dan regresi linier berganda. Hasil penelitian tidak terdapat hubungan antara sikap dengan pelaksanaan triage di UGD RSUD Wonosari, hal ini ditunjukkan dari hasil uji Spearman rank dengan nilai sig 0,354>p-value 0,05. Terdapat hubungan antara pengetahuan dengan pelaksanaan triage di UGD RSUD Wonosari. Hal ini ditunjukkan dari nilai rank spearman 0,004 < p-value 0,05. Sehingga pelaksanaan triage dipengaruhi faktor lain yang tidak terangkum dalam analisis ini. Kesimpulan tidak ada hubungan antara sikap dengan pelaksanaan triage di UGD RSUD Wonosari. Ada hubungan antara pengetahuan dengan pelaksanaan triage di UGD RSUD Wonosari.Kata Kunci: sikap, pengetahuan, pelaksanaan triageNURSE’S ATTITUDE AND KNOWLEDGE RELATED WITH IMPLEMENTATION OF TRIAGEABSTRACTNurses working in emergency units must have the attitude, skills and ability to organize functional abilities under various conditions. Nurses should be able to prioritize patient care on the basis of clinical decision-making where skills are important to nurses in the initial assessment. To support it requires knowledge, attitude and skills in terms of separation of types and gravity of patients in triage, so that in the handling of patients can be more optimal and directed. The purpose of this research is to know the relationship of attitude and knowledge of nurses in the implementation of triage in emergency units Wonosari Hospital. This research uses analytic correlation survey with cross sectional approach. The study population was 15 nurses working in the emergency room, with sampling method in total sampling. The research instrument is questionnaire, data analysis method using spearman rank test and multiple linear regression. The result of this research shows that there is no correlation between attitude with triage implementation in emergency units Wonosari Hospital, it is shown from Spearman rank test with sig value 0,354> p-value 0,05. There is a relationship between knowledge with triage implementation at Wonosari Hospital emergency department. It is shown from spearman rank value 0,004 <p-value 0,05. So the implementation of triage is influenced by other factors not summarized in this analysis. Conclusion there is no relation between attitude with triage implementation in Wonosari Hospital emergency department. There is a relationship between knowledge with triage implementation in emergency units Wonosari Hospital.Keywords: attitude, knowledge, implementation of triage

Does meloxicam provide adequate pain management as a post-operative analgesic in canine ovariohysterectomy patients?

2020 ◽  
Vol 11 (4) ◽  
pp. 192-197
Author(s):  
Gavin Goldsbrough ◽  
Helen Reynolds
Keyword(s):  
Pain Management ◽  
Pain Score ◽  
Pain Scale ◽  
Short Term ◽  
Post Surgery ◽  
Pain Scores ◽  
Significant Difference ◽  
Time Frames ◽  
Adequate Pain Management

Background: Meloxicam is an analgesic agent with anti-inflammatory properties, commonly used in veterinary practices to treat a variety of different long-term medical conditions and is also used as a short-term pain relief following particularly traumatic surgeries. Aims: An observational study was conducted to determine whether meloxicam provides adequate pain management as a post-operative analgesic for canine ovariohysterectomies. Methods: 13 canines were admitted for ovariohysterectomy. Each patient was assessed using the Glasgow composite pain scale (CMPS) prior to surgery during the admission procedure, 15 minutes post-operatively, at discharge and at their post-operative check (POC) 3–5 days after surgery. Results: Data were statistically analysed to determine the overall effectiveness of meloxicam in reducing pain following canine ovariohysterectomy. The results showed a statistically significant difference (Kruskal-Wallis test: H3 =12.98, p=0.005) in pain scores between admission, 15 minutes post operatively, discharge and 3–5 days POC. The greatest decrease in pain score was between 15 minutes post-operatively and POC (Mann-Whitney U test: W=236, n=13, 13, p=0.0014) and between discharge and POC (Mann-Whitney U test: W=227, n=13, 13, p=0.0060). Overall, this demonstrated that there was an improvement in pain suggesting meloxicam is effective between these time frames. In addition, 69.2% (n=9) of patients in the study showed a pain score of 0, indicating an absence of pain, on their final POC. Statistical analysis was also used to determine if there was any difference in pain score between the 3, 4 or 5 day POC pain score. The results show there was no significant difference (Kruskal-Wallis test: H2 =0.090, p=0.638) suggesting that meloxicam's effectiveness was similar across this range of time post surgery. Conclusion: The results from the study indicate that meloxicam is an effective post-operative analgesic for canine patients undergoing an ovariohysterectomy.

scholarly journals Postoperative Analgesic Effects of Laserpuncture and Meloxicam in Bitches Submitted to Ovariohysterectomy

2020 ◽  
Vol 7 (3) ◽  
pp. 94
Author(s):  
Rubia M. Tomacheuski ◽  
Marilda O. Taffarel ◽  
Guilherme S. Cardoso ◽  
Ana A. P. Derussi ◽  
Marcos Ferrante ◽  
...  
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Area Under The Curve ◽  
Postoperative Pain Management ◽  
Pain Scale ◽  
Rescue Analgesia ◽  
Analgesic Effects ◽  
Pain Scores ◽  
Chi Squared ◽  
Perioperative Pain Management

Background: This prospective, randomised and blind study investigated the efficacy of laserpuncture for postoperative pain management in dogs. Method: Sixteen bitches were sedated with acepromazine and randomly treated before ovariohysterectomy with meloxicam 0.2 mg·kg−1 intramuscular or laserpuncture (wavelength 904 mm, frequency 124 Hz, potency 10 Joules, 100 s in each acupoint). Anaesthesia was performed with propofol, isoflurane/O2, and fentanyl. The Glasgow Composite Measure Pain Scale (GCMPS) and Dynamic Interactive Visual Analog Scale (DIVAS) were used to evaluate postoperative pain before and for 24 h after surgery. Morphine was administrated as rescue analgesia when pain scores were ≥3.33 (GCMPS). Differences between treatments, time points, and amount of rescue analgesia between groups were investigated by the Mann–Whitney test and the area under the curve (AUC) for GCMPS, Friedman, and Chi-squared tests, respectively (p < 0.05). Results: Dogs treated with laserpuncture presented lower GCMPS AUC for 24 h and lower GCMPS scores at 2 and 4 h postoperatively (p = 0.04). Three dogs treated with meloxicam required postoperatively rescue analgesia against none treated with laserpuncture. Conclusions: In this preliminary study, laserpuncture mitigated postoperative pain in dogs following ovariohysterectomy, and the technique is a promising adjunct to perioperative pain management in dogs undergoing soft tissue surgery.

The effect of training and experience on mass casualty incident triage performance: Evidence from emergency personnel in a high complexity university hospital

2019 ◽  
Vol 14 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Juan P. Vargas, MD, MSc ◽  
Ives Hubloue, MD, PhD ◽  
Jazmín J. Pinzón, MD ◽  
Alejandra Caycedo Duque, MD
Keyword(s):  
Emergency Department ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
University Hospital ◽  
Trauma Patients ◽  
Post Intervention ◽  
Cross Sectional ◽  
Emergency Department Staff ◽  
Department Staff ◽  
Before And After

Mass casualty incident (MCI) can occur at any time and place and health care institutions must be prepared to deal with these incidents. Emergency department staff rarely learn how to triage MCI patients during their medical or nurse degrees, or through on-the-job training. This study aims to evaluate the effect of training and experience on the MCI triage performance of emergency personnel.Methodology: This was a cross-sectional prospective study that analyzed the performance of 94 emergency department staff on the triage classifications of 50 trauma patients, before and after a short training in MCI triage, while taking into account their academic background and work experience.Results: The participants were assigned initially to one of two groups: low experience if they had less than 5 years of practice, and high experience if they had more than 5 years of practice. In the low experience group, the initial accuracy was 45.76 percent, over triage 45.84 percent, and subtriage 8.38 percent. In the high experience group, the initial accuracy was 53.80 percent, over triage 37.66 percent, and sub triage 8.57 percent.Postintervention Results: In the low experience group, the post intervention accuracy was 63.57 percent, over triage 21.15 percent, and subtriage 15.30 percentage. In the high experience group, the post-intervention accuracy was 67.66 percentage, over triage 15.19 percentage, and subtriage 17.14 percentage.  Conclusion: Upon completion of this study, it can be concluded that MCI triage training significantly improved the performance of all those involved in the workshop and that experience plays an important role in MCI triage performance.

scholarly journals THE EFFECT OF WARM GINGER COMPRESS TOWARDS JOINT PAIN OF THE ELDERLY AT UPT PANTI WERDHA MOJOPAHIT, MOJOKERTO DISTRICT

2018 ◽  
Vol 7 (2) ◽  
pp. 100-105
Author(s):  
Puteri Indah Dwipayanti ◽  
Anik Supriani ◽  
Nanik Nur Rosyidah ◽  
Nurul Mufida
Keyword(s):  
Pain Intensity ◽  
Side Effect ◽  
Joint Pain ◽  
The Elderly ◽  
Pain Scale ◽  
P Value ◽  
Test Design ◽  
Purposive Sampling ◽  
Before And After ◽  
Post Test

Background: There was joint pain that frequently happens by the elderly, which was joint pain. One of actions to abate the joint pain was compress with warm ginger.Objectives: The aims of this research were to identify the effect of warm ginger compress towards joint pain of the elderly at UPT Panti Werdha Mojopahit, Mojokerto District.Method: Design of this research was Pre-Experiment with Type of one group pre-test-post test design. Population of this research was whole of elderly who undergoes joint pain at UPT Panti Werdha Mojopahit Mojokerto district. Technique that used to take sample in this research was purposive sampling with 20 respondents. Data collecting was done before and after warm ginger compress was given use pain scale instrument PAINAD with 1-10 scale. The researcher used Wilcoxon statistic test with value of α=0, 05 to analyze the data.Results: The result of this research wasgained before carried out by warm ginger compress with advance pain scale of 6 respondents (30%), and intermediate pain scale of 10 respondents (50%). After the warm ginger compress was done by 8 respondents (40%) with light pain scale and 11 respondents (55%) with intermediate pain. Data analyzing used statistic test with Wilcoxon P value test 0,003 (α˂ 0, 05). It showed that warm ginger compress effective towards joint pain of the elderly.Conclusion: Looking at the result above shows that warm ginger compress can be created as one of alternative choices to decrease joint pain intensity of the elderly, because this non-pharmacologist treatment uses easy to be obtained ingredient and there is no side effect for the elderly.Key words: Joint Pain, Warm Ginger Compress, Elderly.

scholarly journals PEMBERIAN KOMPRES JAHE DALAM MENGURANGI NYERI SENDI PADA LANSIA DI UPT PSTW KHUSNUL KHOTIMAH PEKANBARU

1970 ◽  
Vol 6 (02) ◽  
pp. 13-16
Author(s):  
Tri Siwi KN
Keyword(s):  
Joint Pain ◽  
Research Result ◽  
The Elderly ◽  
Pain Scale ◽  
P Value ◽  
Average Intensity ◽  
Significant Difference ◽  
Before And After ◽  
Scale Test ◽  
Pain In The Elderly

Gout and rheumatoid arthritis is a disease that is often encountered in the community, one of them on the elderly (the elderly) are characterized by pain that occurs repeatedly in the joints. Ginger compress can be used as a nonpharmacological measures to deal with the pain. This study aims to determine the effectiveness of ginger compress in reducing joint pain in the elderly in UPT PSTW Khusnul Khotimah Pekanbaru. This design of research is a quasi experiment with sampling total sampling with 16 respondents. Data collection tool using pain scale test pre and post administration of ginger compress. The research result shows that the average intensity of joint pain before and after the ginger compress is 2.500. The test results obtained statistical p value = 0.000 where p <α 0:05. this means that there are differences in average significant difference between the intensity of joint pain in the elderly before and after the ginger compress. Is expected to more elderly for routine use as a ginger compress nonpharmacological measures pain in the joints.

scholarly journals Cooled Radiofrequency Ablation of the Genicular Nerves for Treatment of Chronic Knee Pain

2020 ◽  
Author(s):  
Yashar Eshraghi ◽  
Roshina Khan ◽  
Omar Said ◽  
Cruz Velasco ◽  
Maged Guirguis
Keyword(s):  
Radiofrequency Ablation ◽  
Knee Pain ◽  
Rating Scale ◽  
P Value ◽  
Pain Disability Index ◽  
Pain Disability ◽  
Pain Scores ◽  
Chronic Knee Pain ◽  
Before And After ◽  
The Mean

BackgroundChronic knee pain from conditions such as osteoarthritis (OA) is a significant problem in a growing and aging population. Cooled radiofrequency ablation (CRFA) is an emerging technique to treat chronic knee pain. There is significant literature noting the clinical outcomes of CRFA in anatomic locations including the peripheral joints and the lumbar spine. This retrospective study found significant improvements in Pain Disability Index (PDI) scores and Numerical Pain Rating Scale (NPRS) scores for patients with chronic knee pain who underwent cooled radiofrequency ablation (CRFA) therapy of the genicular nerves.ObjectivesThis retrospective study evaluated the effectiveness of CRFA in the general chronic knee pain population.Study DesignRetrospective electronic chart review.SettingOutpatient non-profit practice.MethodsAfter institutional review board approval, we reviewed the data of 205 patients who had undergone cooled radiofrequency ablation therapy of the genicular nerves at a multiple-site pain practice between December 5, 2017 and September 4, 2019. This study’s primary outcome was improvement in Pain Disability Index (PDI) scores. The secondary outcomes were pain scores, assessed by the Numerical Pain Rating Scale (NPRS), and opioid consumption, assessed by daily Morphine Equivalent Dose (MED). From the 205 patients who met inclusion criteria, there were 104 patients who had PDI scores both before and after the CRFA procedure that were collected in the appropriate time frame. For these 104 patients, the pain scores and opioid consumption before and after the CRFA procedure were also collected. The age of the 104 patients ranged from 21 to 89 years. There were 38 males and 66 females.ResultsThe mean PDI score before genicular nerve block and CRFA was 38.7, and the mean PDI score after CRFA was 26.5. After CRFA treatment, 67.38% of patients had a decrease in their PDI scores, 27.9% had no change, and 4.81% had an increase in their PDI scores. P-value <0.001 with 95% CI Median (-11, -7). The mean NPRS score before genicular nerve block and CRFA was 6.98, and the mean NPRS score after CRFA was 4.18. P-value <0.001 with 95% CI Median (-3, -2). The largest group of patients, 49% of patients, had a pain score reduction of 2.25 points, while the next largest group, 17.3% of patients, had a reduction of 0.75 points, followed by 12.5% of patients with a reduction of 3.75 points. When comparing Morphine Equivalent Dose (MED) before and after the CRFA procedure, 37.5% of patients were not on opioid medication at any time during the study; additionally, the MED did not change for the majority of patients (80.77%), while the MED decreased for 13.46% of patients and increased for 5.77% of patients. Mean MED before GNB and CRFA was 17.13 and 15.91 after CRFA. P=0.025 with 95% CI Median (0,0). No serious adverse events were reported.LimitationsRetrospective nature of the study.ConclusionsThis study demonstrates the clinical effectiveness of CRFA for the treatment of chronic knee pain by improvements in PDI scores and NPRS scores for the majority of patients. Results from this study indicate that CRFA treatment provides significant pain relief and reduces the disability caused by chronic knee pain in a patient’s daily life.

Sign in / Sign up

Export Citation Format

Share Document