scholarly journals Administration of Nebulized Ketamine for Managing Acute Pain in the Emergency Department: A Case Series

2020 ◽  
Vol 4 (1) ◽  
pp. 16-20 ◽  
Author(s):  
Jefferson Drapkin ◽  
Aidin Masoudi ◽  
Mahlaqa Butt ◽  
Rukhsana Hossain ◽  
Antonios Likourezos ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chronic Pain ◽  
Pain Relief ◽  
Acute Pain ◽  
Case Series ◽  
Effective Pain Relief

Ketamine administration in sub-dissociative doses in the emergency department (ED) results in effective pain relief in patients with acute traumatic and non-traumatic pain, chronic pain, and opioid-tolerant pain. This case series describes five adult ED patients who received nebulized ketamine for predominantly acute traumatic pain. Three patients received nebulized ketamine at 1.5 milligrams per kilogram (mg /kg) dose, one patient at 0.75 mg/kg, and one patient at 1 mg/kg. All five patients experienced a decrease in pain from the baseline up to 120 minutes. The inhalation route of ketamine delivery via breath-actuated nebulizer may have utility for managing pain in the ED.

scholarly journals The simple query “Do you want more pain medication?” is not a reliable way to assess acute pain relief in patients in the emergency department

CJEM ◽  
2017 ◽  
Vol 20 (1) ◽  
pp. 21-27 ◽  
Author(s):  
Jean-Marc Chauny ◽  
Martin Marquis ◽  
Jean Paquet ◽  
Gilles Lavigne ◽  
Alexis Cournoyer ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Pain Relief ◽  
Acute Pain ◽  
Pain Medication ◽  
Accurate Assessment ◽  
Pain Level ◽  
Pain Problem ◽  
Effective Pain Relief ◽  
Simple Query

AbstractObjectiveThe management of acute pain constitutes an essential skill of emergency department (ED) physicians. However, the accurate assessment of pain intensity and relief represents a clinically challenging undertaking. Some studies have proposed to define effective pain relief as the patient’s refusal for additional analgesic administration. The aim of this study was to verify whether such a refusal is effectively indicative of pain relief.MethodsThis prospective cohort study included ED patients who received single or multiple doses of pain medication for an acute pain problem. Patients were evaluated for pain relief using one Likert scale and two dichotomous questions: Is your pain relieved? and Do you want more analgesics? Non-relieved patients were further analysed using a checklist as to the reasons behind their refusal for supplemental pain medication.ResultsWe have recruited 378 adult patients with a mean age of 50.3 years (±19.1); 60% were women and had an initial mean pain level of 7.3 (±2.0) out of 10. We observed that 68 out of 244 patients who were adequately relieved from pain asked for more analgesics (28%), whereas 51 out of 134 patients who were not relieved from pain refused supplemental drugs (38%). Reasons for refusal included wanting to avoid side effects, feeling sufficiently relieved, and disliking the medication’s effects.ConclusionOver a third of ED patients in acute pain were not relieved but refused supplemental pain medication. Patients have reported legitimate reasons to decline further analgesics, and this refusal cannot be used as an indication of pain relief.

The Use of Intravenous Lidocaine for the Management of Acute Pain Secondary to Traumatic Ankle Injury: A Case Report

2017 ◽  
Vol 31 (1) ◽  
pp. 126-129 ◽  
Author(s):  
Billy Sin ◽  
Diana Gritsenko ◽  
Grace Tam ◽  
Kimberly Koop ◽  
Eva Mok
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Acute Pain ◽  
Single Case ◽  
Case Series ◽  
The United States ◽  
Prescribing Patterns ◽  
Intravenous Lidocaine ◽  
Inpatient Hospitalization ◽  
Acute Distress

Sports-related injuries are a frequent cause of visits to the emergency department (ED) across the United States. A majority of these injuries affect the lower extremities with the ankle as the most frequently reported site. Most sports-related injuries are not severe enough to require inpatient hospitalization; however, they often lead to acute distress and pain which require prompt treatment with analgesics. Approximately 22% of patients who presented to the ED required pharmacotherapy for acute pain management. Opioids have been traditionally used for the management of severe acute pain in the ED; however, there are growing concerns for opioid overuse and misuse. As a result, there is growing controversy regarding the appropriate selection of analgesic agents, optimal dosing, and need for outpatient therapy which has contributed to changes in prescribing patterns of opioids in the ED. Lidocaine, a class 1b antiarrhythmic, has been utilized as an analgesic agent. Its use has been documented for the management of intractable chronic pain caused by cancer, stroke, neuropathies, or nephrolithiasis. However, literature describing the use of intravenous lidocaine for the management of acute pain secondary to trauma is limited to a single case series. This case report describes the use of intravenous lidocaine in a 17-year-old male who presented to the ED in acute distress secondary to ankle dislocation and fracture. This report serves to describe additional clinical experience with intravenous lidocaine for the management of acute pain secondary to ankle fracture in the emergency department.

scholarly journals 254 Chronic Pain is Common 6 Months After an Emergency Department Visit for Acute Pain

2019 ◽  
Vol 74 (4) ◽  
pp. S100
Author(s):  
L.A. Ochoa ◽  
E. Irizarry ◽  
F. Naaem ◽  
B.W. Friedman
Keyword(s):  
Emergency Department ◽  
Chronic Pain ◽  
Emergency Department Visit ◽  
Acute Pain

Acupuncture for Chronic Pain in a Chinese Out-Patient Clinic

1995 ◽  
Vol 13 (1) ◽  
pp. 5-9 ◽  
Author(s):  
Emma Seth
Keyword(s):  
Chronic Pain ◽  
Pain Relief ◽  
Teaching Hospital ◽  
University Teaching ◽  
Response To Treatment ◽  
Effective Pain Relief

During a student elective to China, the use of acupuncture in the treatment of chronic pain was investigated at a university teaching hospital. Sixteen patients in two groups: Osteoarthritis and others, answered questionnaires on their pain and its response to treatment. Acupuncture was found to provide effective pain relief and improved mobility in most patients for a period of 24 hours. This benefit was most marked in those who had had electroacupuncture.

Nursing patients with pain

2009 ◽  
pp. 787-812
Keyword(s):  
Chronic Pain ◽  
Pain Relief ◽  
Drug Use ◽  
Acute Pain ◽  
Pain Assessment ◽  
Pain Control ◽  
Complementary Therapies ◽  
Assessment Tools ◽  
Pharmacological Interventions

Definition and overview of pain788 Acute pain790 Chronic pain792 Pain assessment794 Pain assessment tools796 Methods of relieving pain800 Issues relating to drug use in pain control802 Non-pharmacological interventions to manage pain804 Complementary therapies for pain relief806...

scholarly journals Opioid and non-opioid pain relief after an emergency department acute pain visit

CJEM ◽  
2021 ◽  
Author(s):  
Raoul Daoust ◽  
Jean Paquet ◽  
Alexis Cournoyer ◽  
Éric Piette ◽  
Judy Morris ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Relief ◽  
Acute Pain
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