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8 - Pharmacology of Commonly Utilized Analgesic Agents

from SECTION TWO - ANALGESIA FOR THE EMERGENCY PATIENT

Published online by Cambridge University Press:  03 December 2009

John H. Burton  and
James Miner
By
Eustacia Jo Su
John H. Burton
Affiliation:
Albany Medical College, New York
James Miner
Affiliation:
University of Minnesota
Eustacia Jo Su
Affiliation:
Associate Professor, Oregon Health Sciences University, 3181 SW Sam Jackson Park Road, CDW-EM, Portland, OR 97201, Email: sue@ohsu.edu
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Summary

SCOPE OF THE PROBLEM

Emergency physicians must recognize and treat pain from many causes, from shingles to severe trauma, myocardial infarction to ureterolithiasis. Pain management is an important skill in emergency medicine, requiring recognition and acknowledgment of the patient's pain, adequate treatment, and prompt reevaluation.

Analgesia is the “loss of sensitivity to pain,” or the reduction of pain through therapy. The therapy is not solely pharmacologic in nature: psychological and social support as well as physical positioning for maximum comfort, all help to reduce a patient's perceived pain. Simply reassuring the patient that the provider is aware of the patient's pain and is actively working to relieve the pain can be as important as any medications used.

CLINICAL ASSESSMENT

Approach to the Patient/Situation

It is imperative for physicians to detect and measure pain rapidly so that they can begin treatment promptly and assess its effect. To the physician, the patient may not appear to be in pain, but he or she may actually be in severe pain. Careful listening, observation, and repeated solicitation may be necessary to fully elicit an admission of pain. Assessment must be both qualitative (is pain present?) and quantitative (how much does it hurt? Has it improved with treatment?). Early reassessment must follow any treatments to ensure that it was adequate and without adverse effects, and that repeated doses are given promptly if needed.

Type
Chapter
Information
Emergency Sedation and Pain Management , pp. 43 - 54
Publisher: Cambridge University Press
Print publication year: 2008

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References

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