Acute Pain Management

Acute pain management is improving steadily over the past few years, but training and professional education are still lacking in many professions. Untreated or undertreated acute pain could have detrimental effects on the patient in terms of comfort and recovery from trauma or surgery. Acute undertreated pain can decrease a patient's vascular perfusion, increase oxygen demand, suppress the immune system, and possibly risk increased incidence of venous thrombosis. Although acute postoperative pain needs to be managed aggressively, patients are most vulnerable during this period for developing adverse effects, and therefore, patient assessment and careful drug therapy evaluation are necessary processes in therapeutic planning. Acute pain management requires careful and thorough initial assessment and follow-up reassessment in addition to frequent dosage adjustments, and managing analgesic induced side effects. Analgesic selection and dosing must be based on the patient's past and recent analgesic exposure. There is no single acute pain management regimen that is suitable for all patients. Analgesics must be tailored to the individual patient.

Hypolimnetic oxygenation: predicting performance using a discrete-bubble model

Stratification of water-supply reservoirs frequently results in substantial hypolimnetic oxygen depletion with a resulting negative impact on raw water quality. Hypolimnetic oxygenators are used to add oxygen to the hypolimnion without significantly disrupting the thermal density structure. The three most common devices are the airlift aerator, the Speece Cone, and the bubble-plume diffuser. A discrete-bubble model based on fundamental principles has previously been shown to hold considerable promise for predicting the performance of airlift aerators and the Speece Cone. In this paper, we have further verified this model by comparing its predictions to a series of pilot-scale experimental measurements and have also demonstrated its ability, under somewhat idealized conditions, to predict the full-scale performance of a bubble-plume diffuser in a stratified reservoir. The potential for the diffused-bubble aeration system to increase oxygen demand, and the rate at which nitrogen builds up during operation and de-gasses following destratification, are also considered.