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 i...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Columns Patient Care Source Type: news

Related Links:

CONCLUSION: In patients with cardiogenic shock after delivery, early transthoracic echocardiography is a non-invasive tool that can rapidly narrow the differential diagnosis. PMID: 31324480 [PubMed - as supplied by publisher]
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research
This is a guest post from one of our patients. She is 32 and recently froze her eggs at Malpani Infertility ClinicOur 20 ’s and early 30's may be theeasiest time to have a baby but it's not always the best time - for a lot of good reasons. We are at the top of our career and want to grow professionally; we want to prepare emotionally and financially to be parents ; and we are unwilling to settle for Mr. RightNow instead of Mr. Right.The problem is that the biological clock is ticking on - and we can hear it loud and clear ! The good news is that with a little medical help , we can freeze time , to plan for the future...
Source: Dr.Malpani's Blog - Category: Reproduction Medicine Source Type: blogs
ConclusionsThe REAPSER study includes a cohort of patients with recent-onset PsA, before the disease course was modified by disease-modifying antirheumatic drugs prescribed in rheumatology departments. Exhaustive information collected in each visit is expected to be an important data source for future analysis.ResumenObjetivosDescribir la metodología del Registro Español de Artritis Psoriásica de reciente comienzo de la Sociedad Española de Reumatología (REAPSER), así como sus fortalezas y limitaciones. El objetivo principal del proyecto es identificar factores pronósticos d...
Source: Reumatologia Clinica - Category: Rheumatology Source Type: research
ConclusionThe unique sonographic presentation of rice bodies in the chronic subacromial-subdeltoid bursitis makes it easy to be diagnosed confidently, but it is difficult to be recognized, due to its rare occurrence.
Source: Critical Ultrasound Journal - Category: Radiology Source Type: research
AbstractA decision support system (DSS) was developed to predict postoperative outcome of a kidney stone treatment procedure, particularly percutaneous nephrolithotomy (PCNL). The system can serve as a promising tool to provide counseling before an operation. The overall procedure includes data collection and prediction model development. Pre/postoperative variables of 254 patients were collected. For feature vector, we used 26 variables from three categories including patient history variables, kidney stone parameters, and laboratory data. The prediction model was developed using machine learning techniques, which include...
Source: Australasian Physical and Engineering Sciences in Medicine - Category: Biomedical Engineering Source Type: research
This study aims to (1) verify the cardioprotective effect of ω-3 fish oil fat emulsion in vivo and in vitro, and (2) determine whether aldehyde stress is a protective mechanism. For modeling purposes, we pretreated rats with 2 ml/kg of a 10% ω-3 fish oil fat emulsion for 5 days in order to generate a sufficient aldehyde stress response to trigger the production of antioxidant enzymes, and we obtained similar response with H9C2 cells that were pretreated with a 0.5% ω-3 fish oil fat emulsion for 24 h. ω-3 fish oil fat emulsion pretreatment in vivo reduced the myocardial infarct size, decreased th...
Source: Biomedicine and Pharmacotherapy - Category: Drugs & Pharmacology Source Type: research
Publication date: Available online 20 July 2019Source: BurnsAuthor(s): Sarvnaz Sepehripour, Elizabeth Chipp
Source: Burns - Category: Dermatology Source Type: research
Publication date: Available online 20 July 2019Source: Best Practice &Research Clinical AnaesthesiologyAuthor(s): Mark R. Jones, Matthew B. Novitch, Sudipta Sen, Nadia Hernandez, Johanna Blair De Haan, Rebecca A. Budish, Christopher Bailey, Joseph Ragusa, Pankaj Thakur, Vwaire Orhurhu, Ivan Urits, Elyse M. Cornett, Alan David KayeAbstractSurgeries and chronic pain states of the upper extremity are quite common and pose unique challenges for the clinical anesthesiology and pain specialists. Most innervation of the upper extremity involves the brachial plexus. The four most common brachial plexus blocks performed in clin...
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research
Astudy published last month in theJournal of the American Heart Association electronic cigarette use concluded that vaping is a cause of heart attacks, raising the risk of having a heart attack about two-fold. One of the co-authors publicized the study on his blog under the title " More evidence thate-cigs cause heart attacks. "This was a cross-sectional study using data from the baseline survey of the Population Assessment of Tobacco and Health (PATH) Study collected in 2013-2014. The investigators examined the relationship between respondents reporting that theyever had a heart attack and that they currently va...
Source: The Rest of the Story: Tobacco News Analysis and Commentary - Category: Addiction Source Type: blogs
Publication date: August 2019Source: The Annals of Thoracic Surgery, Volume 108, Issue 2Author(s): Yi-Tso Cheng, Arthur R. Garan, Joseph Sanchez, Paul Kurlansky, Masahiko Ando, Marisa Cevasco, Melana Yuzefpolskaya, Paolo C. Colombo, Yoshifumi Naka, Hiroo Takayama, Koji TakedaBackgroundThe use of short-term mechanical circulatory support (ST-MCS) has increased for refractory cardiogenic shock. However, there are scant data about bridge-to-recovery patients.MethodsWe retrospectively reviewed 502 patients with cardiogenic shock who received venoarterial extracorporeal membrane oxygenation or a temporary surgical ventricular a...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
More News: Arrhythmia | Back Pain | Burns | Cardiology | Fentanyl | Heart | Heart Attack | Hospital Management | Hospitals | Hypertension | Kidney Stones | Pain | Pain Management | Shingles | Skin | Urology & Nephrology