Pain management in the emergency service
The treatment of pain can be approached from different points within its physiopathology by Nj Arthritis Doctor. It is important that the trafficker knows where and how the medicines that he prescribes act, to try to make a multimodal approach to pain management and to avoid the adverse effects and contraindications of them. This means that if, for example, a patient presents to the ED with pain 8/10 originating from a typical lumbar pain syndrome, the patient will require, if desired, intravenous analgesia and more than one medication. This combination of drugs must attack different pathways of pain, combining for example non-steroidal anti-inflammatory analgesics (NSAIDs), opioids and paracetamol. The treatment of this patient should in no case combine 2 NSAIDs as this would only increase the risks of adverse effects, without improving the analgesic effects of the drugs you are using. Also, the trafficker should try to obtain synergistic effects of the drugs he uses, such as in the combination of acetaminophen with opioids.
A high impact intervention for the correct use of these medications has been the incorporation of clinical pharmacologists within the emergency personnel. These Nj Pain Management, supervise and follow up the prescriptions, both in the emergency unit and the discharge instructions. Among its functions are to cooperate with the team performing pharmacokinetic analysis of special patients to adjust their doses or determine the presence of problems associated with medication such as cross allergies, drug interactions, contraindications, among others. Finally, they record the errors of prescription and administration technique. It has been shown that all these interventions can reduce the errors of general medication, up to 80%.
Things to consider while taking pain treatment
Another important point of Clifton Pain Management is the relief of concomitant symptoms such as anxiety, nausea and dyspnea, since without the management of pain; the relief of the patient's suffering will not be obtained. There are numerous drugs recommended by Pain Management Doctors Nj that can be associated with analgesics for the management of these as benzodiazepines, antiemetics, antispasmodics, as well as the use of other techniques, for example, use of non-invasive mechanical ventilation, in the most extreme cases.
In the group of pediatric patients, we must have a comprehensive management policy for this problem and transform the emergency services into "Units without pain". The attention of children who consult for acute pain or those who require analgesia for painful procedures, presents a great challenge, since it generates stress in patients, relatives and health team. Sub optimal analgesia is unacceptable in this group of patients. For example, in a study of the PERC group in children with suspected acute appendicitis, the average " triage to analgesia " time was 200 minutes, more than 40% of the analgesia administrations were performed after the surgeon's evaluation and in addition, over 40% of children received analgesia after abdominal ultrasound, with the obvious associated discomfort 15 . Later it will be explained, that removing pain early, does not impede, but on the contrary, improves the diagnostic process.
It is interesting to highlight two novel strategies for a standardized comprehensive management with the purpose of projecting itself as an emergency service "without pain for children".