Examining When to Provide Pain Management for Patients

Eradicating pain has been a focus of medicine throughout history, from the early use of cocaine to the current use of fentanyl. As a prehospital provider in 2016, the standard of care for EMS is to provide interventions that control patients' pain. The patient suffering from chest pain or an acute myocardial infarction (AMI) is a prime target for pain mitigation. Without it, many patients get extremely anxious and can present with tachycardia, tachypnea, hypertension and premature ventricular contractions, all of which aren't good for a patient already in distress. Nitroglycerine helps reduce chest pain by increasing myocardial blood flow through dilation of the coronary arties which, in turn, improves collateral blood flow to ischemic regions of the heart and may reduce the risk of arrhythmias. We readily treat patients with significant fractures and painful burns with IV narcotics in the field. In many EMS systems this is done on standing orders, yet there are numerous other extremely painful conditions that we evaluate and transport as EMS providers that should be considered eligible for pain management prior to hospital arrival. These include kidney stones, severe back spasms and even shingles—an unrelenting condition that can make the patient feel like sandpaper is scraping against sunburned skin. Our protocols rarely allow us to treat these painful conditions on standing orders—we need to take initiative and contact medical direction for permission to intervene...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Columns Patient Care Source Type: news