scholarly journals The pain in the Emergency Department: Choosing and treating wisely before and during the COVID-19 era

2021 ◽  
Vol 17 (4) ◽  
Author(s):  
Erika Poggiali ◽  
Fabio De Iaco
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Acute Pain ◽  
The Elderly ◽  
Point Of View ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
The Right ◽  
Anxiety Depression ◽  
Adequate Management

Pain is a frequent reason for referral to the Emergency Department (ED). Adequate management of pain is a moral and ethical imperative. If not correctly treated, acute pain can cause physical and psychological complications, and become chronic with severe consequences such as anxiety, depression, and social isolation. As consequence, emergency clinicians should treat pain as soon as possible, avoiding delays even in case of acute abdominal pain. Pain management is particularly complex in the elderly and emergency clinicians should always consider AGS Beers criteria ® to avoid inappropriate medications, severe side-effects, and drug-drug interactions. Pain is also a common cause of delirium in older patients. The SARS CoV-2 infection not only can cause acute pain, but also exacerbate chronic pain, particularly in the elderly, who are at high risk to be infected. Looking at all this evidence, emergency clinicians should treat pain with different strategies according to their experience and cultural background, making the right choice for each patient. This work is a critical review of the pain management in the ED, with a particular attention on the effects of COVID-19 in the EDs. We conducted a systematic search of the following databases: PubMed, Google Scholar, Science Direct, Medline from 2000 to 2020, using the keywords of “pain”, “emergency”, “COVID19”, “elderly”, “palliative care”, “ketamine”, “dexmedetomidine”, and “post-traumatic stress disorder”. The aim of this review is to help emergency clinicians to correctly manage pain in the ED with a new point of view regarding the pain management in COVID-19 patients.

Pain management in major pediatric trauma and burns

2021 ◽  
pp. 181-191
Author(s):  
Greta M. Palmer ◽  
Franz E. Babl
Keyword(s):  
Emergency Department ◽  
Neuropathic Pain ◽  
Intensive Care ◽  
Pain Management ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Pediatric Trauma ◽  
Post Traumatic Stress ◽  
Primary Event ◽  
Post Traumatic

Pain management in major pediatric trauma and burns remains challenging. The care phases include prehospital, the Emergency Department, ward, and intensive care, with multiple operative and procedural interventions (as inpatients and, later, outpatients). Distress, anxiety, post-traumatic stress disorder (from the primary event, and in-hospital and postdischarge course), itch, deranged sleep, nociceptive and neuropathic pain occur frequently and can persist. This chapter presents the pharmacological and nonpharmacological interventions employed during the various phases to address pain and associated issues in major trauma and burns patients.

scholarly journals Knowledge, attitudes, and practices of Cameroonian physicians with regards to acute pain management in the emergency department: a multicenter cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Paul Owono Etoundi ◽  
Junette Arlette Metogo Mbengono ◽  
Ferdinand Ndom Ntock ◽  
Joel Noutakdie Tochie ◽  
Dominique Christelle Anaba Ndom ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Acute Pain ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Acute Pain Management ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Knowledge Attitudes And Practices

scholarly journals Assessing the Feasibility of Providing a Family Skills Intervention, “Strong Families”, for Refugee Families Residing in Reception Centers in Serbia

2021 ◽  
Vol 18 (9) ◽  
pp. 4530
Author(s):  
Aala El-Khani ◽  
Karin Haar ◽  
Milos Stojanovic ◽  
Wadih Maalouf
Keyword(s):  
Mental Health ◽  
Parenting Practices ◽  
Humanitarian Aid ◽  
Post Traumatic Stress ◽  
Emotional Challenges ◽  
Refugee Families ◽  
Quantitative Results ◽  
Post Traumatic ◽  
Family Mental Health ◽  
Anxiety Depression

War exposure and forced displacement threatens the wellbeing of caregivers and their children, leaving them at risk of negative outcomes, such as elevated rates of anxiety, depression and post-traumatic stress disorder. The importance of engaged, responsive and stable parenting for positive child wellbeing has been documented across diverse cultural and economic backgrounds. Despite the higher need for caregivers to be nurturing in challenging settings, they struggle to provide adequate support for their children due to lack of resources or their inability to deal with their own emotional challenges. A feasibility study was conducted of a new, open-access and light-touch family skills intervention, Strong Families (for families in humanitarian and challenged settings) on refugee families residing in Reception Centers in Serbia. Questionnaires and interviews were completed by participating caregivers and facilitators. Qualitative results indicated that the intervention was feasible to run in this humanitarian context, that caregivers viewed the intervention as culturally acceptable and complemented the quantitative results that showed promise for enhancing child behavior and family functioning tested indicators. Despite being a light intervention, Strong Families indicated improvement on child mental health, parenting practices and parent and family adjustment skills. Prioritizing family mental health and functioning as a primary need that parallels that of accessing physical medical care, sanitation and clean water must be the definitive next step in humanitarian aid.

scholarly journals Likely Exacerbation of Psychological Disorders from Covid-19 Response

2021 ◽  
Vol 12 ◽  
pp. 215013272110167
Author(s):  
Tara Rava Zolnikov ◽  
Tanya Clark ◽  
Tessa Zolnikov
Keyword(s):  
Psychological Disorders ◽  
Emotional Reactions ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Current State ◽  
The Face ◽  
Adults And Children ◽  
Post Traumatic ◽  
Anxiety Depression

Anxiety and fear felt by people around the world regarding the coronavirus pandemic is real and can be overwhelming, resulting in strong emotional reactions in adults and children. With depressive and anxiety disorders already highly prevalent in the general population (300 million worldwide), depression and/or anxiety specifically because of the pandemic response is likely. Moreover, the current state of panic in the face of uncertainty is apt to produce significant amounts of stress. While this situation has the potential to cause psychological disorders in previously unaffected populations, perhaps more impactful is the exacerbation of symptoms of many existing disorders including anxiety, depression, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD) and hoarding disorder.

scholarly journals Depressive, anxiety, and post-traumatic stress symptoms affecting hospitalized and home-isolated COVID-19 patients: a comparative cross-sectional study

2021 ◽  
Vol 28 (1) ◽  
Author(s):  
Amany Elshabrawy Mohamed ◽  
Amira Mohamed Yousef
Keyword(s):  
Traumatic Stress ◽  
Depression Scale ◽  
Post Traumatic Stress ◽  
Stress Symptoms ◽  
Hospital Anxiety Depression Scale ◽  
Medical Occupation ◽  
Group A ◽  
Post Traumatic ◽  
Group B ◽  
Anxiety Depression

Abstract Background Coronavirus has affected more than 100 million people. Most of these patients are hospitalized in isolation wards or self-quarantined at home. A significant percentage of COVID-19 patients may experience psychiatric symptoms. This study attempts to assess depressive, anxiety, and post-traumatic stress symptoms in home-isolated and hospitalized COVID-19 patients, besides whether the isolation setting affected these symptoms’ presentation. Results The study involved 89 patients with confirmed COVID-19 virus, and the patients were divided into 2 groups: 43 patients in the home-isolated group (group A) and 46 patients in the hospital-isolated group (group B). The majority of subjects were male and married; also, they were highly educated. 30.2% from group A and 47.8% from group B had a medical occupation. There was a statistically significant difference (p= 0.03) between both groups in the presence of chronic disease. There was a statistically significant increase in suicidal thoughts in the home-isolated group (37.2%) (p = 0.008**). We found a statistically significant increase in the abnormal scores of Hospital Anxiety Depression Scale–Depression (HADS–Depression) in the home-isolated group (69.7%) compared to the hospital-isolated group (32.6%) (p <0.001**) which denotes considerable symptoms of depression. Moreover, we found that (32.6%) from the home-isolated group and (39.1%) from the hospital-isolated group had abnormal scores of Hospital Anxiety Depression Scale–Anxiety (HADS–Anxiety) which denotes considerable symptoms of anxiety. Also, we found 66.7% and 87.2% scored positive by the Davidson Trauma Scale (DTS) in the home-isolated group and hospital-isolated group, respectively. Which was statistically significant (p = 0.02**). On doing a binary logistic regression analysis of HADS and DTS with significantly related independent factors, we revealed that lower education levels and family history of psychiatric disorder were risk factors for abnormal HADS–Anxiety scores in COVID-19 patients. The medical occupation was a protective factor against having abnormal HADS–Depression scores in COVID-19 patients, while home isolation was a risk factor. On the contrary, the medical occupation was a risk factor for scoring positive in DTS in COVID-19 patients. Simultaneously, low levels of education and home isolation were protective factors. Conclusion A significant number of patients diagnosed with the COVID-19 virus develop depressive, anxiety, and post-traumatic stress symptoms, whether they were isolated in the hospital or at home; besides, the isolation setting may affect the presenting symptoms.

Anxiety, Depression, and Post-traumatic Stress a month after 2019 Cyclone Fani in Odisha, India

2021 ◽  
pp. 1-8
Author(s):  
Nilamadhab Kar ◽  
Narendra Nath Samantaray ◽  
Shreyan Kar ◽  
Brajaballav Kar
Keyword(s):  
Traumatic Stress ◽  
Severe Depression ◽  
Considerable Proportion ◽  
Post Traumatic Stress ◽  
Disaster Victims ◽  
Stress Symptoms ◽  
Short Period ◽  
Post Traumatic ◽  
Anxiety Depression ◽  
Severe Anxiety

Abstract Background: Early Identification of disaster victims with mental health problems may be useful, but information within a short period after a disaster is scarce in developing countries. This study examined anxiety, depression, and post-traumatic stress symptoms at 1 month following 2019 Cyclone Fani in Odisha, India. Method: Post-traumatic stress symptoms (PTSS) were assessed by the Primary care PTSD screen for DSM 5 (PC-PTSD-5), anxiety symptoms by the Generalised Anxiety Disorder (GAD-7), and depression by the Patient Health Questionnaire (PHQ-9). The survey included participants’ disaster experience e.g., evacuation, fear of death, injury, death in family, damage to house, difficulty for food, displacement, and effect on livelihood. Results: Proportion of sample (n = 80) with probable PTSD was 42.9%, with severe anxiety was 36.7%, moderately severe depression was 16.5%, and severe depression was 3.8%. Suicidal cognitions were reported to increase by 14%. Comorbidity was common; with significant (P < 0.01) correlation between PTSS and anxiety (r = 0.69), depression (r = 0.596), and between anxiety and depression (r = 0.63). Damage of house and displacement were associated significantly with PTSD; evacuation and displacement with moderate and severe depression; and displacement with severe anxiety. No specific demographic factors were significantly linked to the psychiatric morbidities. Conclusion: A considerable proportion of victims had psychiatric morbidities at 1 month. Associated risk factors included housing damages, evacuation, and displacement, suggesting the need to improve the disaster-management process.

scholarly journals Commonly Used Agent for Acute Pain Management of Sickle Cell Anemia in Saudi Emergency Department: a Narrative Review

2021 ◽  
Author(s):  
Reem A. Hejazi ◽  
Nameer A. Mandourah ◽  
Aryaf S. Alsulami ◽  
Hussain T. Bakhsh ◽  
Reem M. Diri ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Acute Pain ◽  
Narrative Review ◽  
Acute Pain Management

Prisoner’s insomnia prevalence, insomnia associated factors and interventions with sleep as an outcome: a review and narrative analysis

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Chris Griffiths ◽  
Farah Hina
Keyword(s):  
Narrative Analysis ◽  
Associated Factors ◽  
Behavioural Therapy ◽  
Post Traumatic Stress ◽  
Content Type ◽  
Cognitive Behavioural ◽  
High Prevalence ◽  
Randomised Control Trials ◽  
Post Traumatic ◽  
Anxiety Depression

Purpose Insomnia is highly prevalent in prisoners. The purpose of this paper is a review of research evidence on interventions with sleep as an outcome (2000 to 2020) and rates of insomnia prevalence and associated factors in prisons (2015 to 2020). Design/methodology/approach An internet-based search used Medline, PubMed, PsycINFO (EBSCOhost), Embase, Web of Science and Scopus. Seven interventions and eight sleep prevalence or sleep-associated factor papers were identified. Findings Intervention research was very limited and the quality of the research design was generally poor. Interventions such as cognitive behavioural therapy for insomnia (CBT-I), yoga and mindfulness can be beneficial in a prison setting. This review identified a high prevalence of insomnia in prisons across the world, which was supported by recent evidence. Factors associated with insomnia include anxiety, depression, post-traumatic stress disorder, personality disorder and pain. Research limitations/implications There is a need for appropriately powered randomised control trials of CBT-I in prisons and a need to use objective measures of sleep quality. Originality/value Due to a lack of an up-to-date review, this paper fulfils the need for a review of the evidence on interventions in prison settings with sleep as an outcome, rates of insomnia prevalence and associated factors in prisons.

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