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<< An Evidence-Based Approach To Traumatic Pain Management In The Emergency Department (Trauma CME)

Time- And Cost-Effective Strategies In Pain Management

  • Regional Anesthesia: Regional anesthetic techniques can decrease the amount of anesthetic needed and sometimes obviate the need for procedural sedation analgesia.125 Many techniques can be performed relatively quickly and easily, benefitting both the patient and provider.
  • Nonphysician-Directed Pain Management: Physicians are an expensive and limited resource, with a variety of duties beyond providing analgesia. Nursing protocols can be developed to treat pain with standing orders, which have been shown to safely improve time to analgesia and pain scores.182-185 Patient-controlled analgesia has been used extensively in the postoperative setting. More recently, it has shown improved analgesia and patient satisfaction in the ED.186
  • Oral/Transmucosal Medications: In many situations, oral or transmucosal medication administration will provide similar analgesia at reduced cost.187 They are often also easier to administer, which may result in decreased time to effect when accounting for the time required to place IV access.
  • Over-The-Counter/Generic Medications: Many analgesics are available at reduced cost to patients as over-the-counter (OTC) and/or generic formulations. Often, a generic substitution may be suggested on a written prescription (“substitution permitted”), but patients are not always aware that this is an option for OTC formulations as well. A simple explanation that the medication you are recommending (eg, Motrin® or Tylenol®) may be available as a less-expensive and equally effective generic form (ibuprofen or acetaminophen) may help your patients more easily afford their treatment.
  • Nonpharmacologic Management: Not all methods of pain control involve expensive medications. Immobilization techniques can often be found with inexpensive materials (eg, plaster). Elevation and ice are easy and cost-effective means of decreasing swelling that may contribute to pain. Nontraditional therapies, such as acupuncture/acupressure or hypnosis, may provide benefit to some patients. Decreasing anxiety with a discussion or verbal reassurance is almost certain to augment pain relief.

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Last Modified: 05/04/2016
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