The sky isn ’t the limit for NSAIDs analgesia
Using the one-dose/one-size approach is detrimental to patient health.
As an ED clinician, I take enormous pride in taking care of patients presenting to my ED in pain. I take even bigger pride in the progress that Emergency Medicine has made over the past 15 years to perfect pain management.
Armed with a solid knowledge base, great evidential support, and a broad array of analgesics, ED doctors across the country are providing effective and safe relief of pain.
However, from time to time I am still reminded that so-called “traditional” teaching is pushing for the “one-dose,” “one-size” fits all approach (0.1 m...
Source: EPMonthly.com - April 11, 2022 Category: Emergency Medicine Authors: Jeffrey Lyles Source Type: news
The sky isn ’t the limit for NSAIDs analgesia
Using the one-dose/one-size approach is detrimental to patient health.
As an ED clinician, I take enormous pride in taking care of patients presenting to my ED in pain. I take even bigger pride in the progress that Emergency Medicine has made over the past 15 years to perfect pain management.
Armed with a solid knowledge base, great evidential support, and a broad array of analgesics, ED doctors across the country are providing effective and safe relief of pain.
However, from time to time I am still reminded that so-called “traditional” teaching is pushing for the “one-dose,” “one-size” fits all approach (0.1 m...
Source: EPMonthly.com - April 11, 2022 Category: Emergency Medicine Authors: Jeffrey Lyles Source Type: news
Are you under treating pain in your ED?
Conclusion
While I commend efforts to minimize any harm our therapies may have on patients, I remain unconvinced that using the maximum recommended dose of NSAIDs in the Emergency Department will have a net negative effect on them. In fact, given the systemic issue of oligoanalgesia in the ED, I’ll happily stick with 800 mg of ibuprofen, whether it be for my patients or myself.
References:
Motov S, Masoudi A, Drapkin J, et al. Comparison of Oral Ibuprofen at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial. Ann Emerg Med. 2019;74(4):530-537. doi:10.1016/j.anne...
Source: EPMonthly.com - April 11, 2022 Category: Emergency Medicine Authors: Jeffrey Lyles Source Type: news
Are you under treating pain in your ED?
Conclusion
While I commend efforts to minimize any harm our therapies may have on patients, I remain unconvinced that using the maximum recommended dose of NSAIDs in the Emergency Department will have a net negative effect on them. In fact, given the systemic issue of oligoanalgesia in the ED, I’ll happily stick with 800 mg of ibuprofen, whether it be for my patients or myself.
References:
Motov S, Masoudi A, Drapkin J, et al. Comparison of Oral Ibuprofen at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial. Ann Emerg Med. 2019;74(4):530-537. doi:10.1016/j.anne...
Source: EPMonthly.com - April 11, 2022 Category: Emergency Medicine Authors: Jeffrey Lyles Source Type: news
Keep an eye out
Discussion
Beanbag ballistic projectiles, as well as other Kinetic Impact Projectiles (KIPs), have been scrutinized in their role for crowd control due to the risk of blunt trauma including skull fractures, intracranial bleeds and retained beanbag components.[1]
Previous research into injury rates from KIPs shows that 15.5% of patients who presented for injuries from KIPs had permanent disabilities — typically from ocular trauma or abdominal organ trauma, which required subsequent operations. About 84.2% of patients had permanent blindness if they sustained ocular trauma. KIPs utilizing metal, including beanbag rounds, h...
Source: EPMonthly.com - April 11, 2022 Category: Emergency Medicine Authors: Jeffrey Lyles Source Type: news
Keep an eye out
Discussion
Beanbag ballistic projectiles, as well as other Kinetic Impact Projectiles (KIPs), have been scrutinized in their role for crowd control due to the risk of blunt trauma including skull fractures, intracranial bleeds and retained beanbag components.[1]
Previous research into injury rates from KIPs shows that 15.5% of patients who presented for injuries from KIPs had permanent disabilities — typically from ocular trauma or abdominal organ trauma, which required subsequent operations. About 84.2% of patients had permanent blindness if they sustained ocular trauma. KIPs utilizing metal, including beanbag rounds, h...
Source: EPMonthly.com - April 11, 2022 Category: Emergency Medicine Authors: Jeffrey Lyles Source Type: news
Time for less is more for the EM Workforce
Increasing standards could enhance education, training to avoid physician surplus.
Based on recent EM workforce studies, a reduction of ~ 40% for new emergency medicine (EM) residents will be needed to prevent a significant oversupply of emergency physicians (EPs).
An oversupply of EPs would have a very negative impact on EM and may lead to decreases in job security, practice rights, patient advocacy and compensation.
As a result, the attractiveness of EM as a specialty will suffer, which would result in less competitive applicants entering EM in the future, less qualified EPs and a negative impact on patient care. Balan...
Source: EPMonthly.com - April 5, 2022 Category: Emergency Medicine Authors: Jeffrey Lyles Source Type: news
Night Shift: Mavericks
I just celebrated my 70th birthday recently. It was a wonderful time with my family. But all the well wishes from my colleagues, all of whom are much smarter than I, reminded me of all the lies told about people at their funerals.
It made me wonder if they knew something about my health that I didn’t. It reminded me of the guy who asked his old family doctor if his condition was terminal. The old timer just looked at him and said, “I don’t really know how long you have. But if I were you, I wouldn’t make any investments in all day suckers or long playing records.”
So just in case, I thought I might make...
Source: EPMonthly.com - April 5, 2022 Category: Emergency Medicine Authors: Jeffrey Lyles Source Type: news
“ If I evacuate to the west to some safe place, people will die ”
This article was originally published in Emergency Physicians International.
On Feb. 23, Dr. Vitaliy Krylyuk was helping run a medical conference in Kremenets City — a small, picturesque town in the western region of Ukraine. Early in the morning of Feb. 24, as Krylyuk and his colleagues prepared for a series of EMS competitions, they heard the news. Russia was invading their country. Ukraine was under attack.
For about an hour they watched and waited, locked on the news reports. Then, one by one the emergency physicians and various staff got in their cars and left. Rather than stay in the relative safety of western U...
Source: EPMonthly.com - March 21, 2022 Category: Emergency Medicine Authors: Jeffrey Lyles Source Type: news
EP Talk Ep. 51 – with Laleh Gharahbaghian
Don’t miss this discussion of non-convulsive status epileptics with Laleh Gharahbaghian, MD.
It will open your eyes to a problem I suspect many, if not most EPs, are currently missing.
It is a point of care test that needs to be in every, yes EVERY emergency department.The post EP Talk Ep. 51 – with Laleh Gharahbaghian first appeared on Emergency Physicians Monthly. (Source: EPMonthly.com)
Source: EPMonthly.com - February 25, 2022 Category: Emergency Medicine Authors: Jeffrey Lyles Source Type: news
Much adieu about ’22?
From pandemic strife to burnout, the EPM board predicts what awaits this year.
COVID-19 continued to roar through 2021 with vaccinations providing yet another divisive arena. Social media remained a battleground on COVID treatments and deterrents as ERs saw fluxes with the Delta and Omnicron variants. Staffing was reduced then increased to deal with the virus while physician burnout became more than a talking point.
With 2022 poised to present new problems as the world continues to get a hold on COVID, the Emergency Physicians Monthly board brought back their predictive technology and crystal balls to predict what’s in ...
Source: EPMonthly.com - February 1, 2022 Category: Emergency Medicine Authors: Jeffrey Lyles Source Type: news
