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Prehospital analgesia

from General considerations

Published online by Cambridge University Press:  18 December 2009

Stephen H. Thomas
Affiliation:
Harvard Medical School
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Summary

This chapter overviews the importance of analgesia as an important endpoint in prehospital care. Analgesia's importance is magnified by the frequency with which EMS providers interact with injured patients in significant pain. The chapter focuses on prehospital medication administration, with the understanding that not all medications will be available in all EMS systems. The perceived problem with out-of-hospital analgesia administration is that the drugs incur risk of hemodynamic or respiratory compromise. Examination-related issues other than the neurological evaluation are also prominent reasons for physicians not to administer prehospital analgesia. The opioids are the primary analgesic approach available to most EMS services. The prototypical opioid for use in prehospital care is morphine, which is demonstrated to be useful for a variety of adult and pediatric conditions encountered in EMS. Regional nerve blocks with local anesthetic injection are efficacious for field use in settings where physician prehospital providers are available.
Type
Chapter
Information
Emergency Department Analgesia
An Evidence-Based Guide
, pp. 19 - 30
Publisher: Cambridge University Press
Print publication year: 2008

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