Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e
|Section 5. Analgesia, Anesthesia, and Procedural Sedation >|
Chapter 38. Acute Pain Management in Adults
Sections: Acute Pain Management in Adults: Introduction, Pathophysiology, Evaluation, Pain Scale Performance in Special Patient Populations, Pain Treatment, Disposition and Follow-Up, Acknowledgment, References.
Topics Discussed: pain management.
than 60% of patients registering in EDs have pain as their
primary symptom.1 Whereas up to 40% of
those patients may have chronic pain underlying their complaint,
close to 45% of all emergency patients are suffering from
acute pain.2 Recognition of our collective failure
as a specialty to adequately assess and manage pain started in 1989
with Wilson and Pendleton's seminal article defining ED
oligoanalgesia.3 All patients are at risk for oligoanalgesia,
but certain subgroupsethnic minorities, the aged, the
very young, and those with diminished cognitive functionare
more at risk for inadequate pain control4 (Table 38-1). The Joint Commission (formerly
the Joint Commission on Accreditation of Healthcare Organizations)
has mandated standardized assessments of pain in the ED, although
some have questioned their validity.5 Other guidelines
have been published by the Agency for Health Care Policy and Research.6 These
documents serve as useful starting points but should be supplemented
with more detailed and current information as appropriate...."
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