Acute Traumatic Pain Management in the Emergency Department (Pain Management CME)(Trauma CME) -
About This Resource
Choosing the optimal traumatic pain management strategy has never been more important, and the options have never been so diverse. This Special Report updates you on the latest in analgesia in the emergency department, including these questions:
What is the current evidence on nonpharmacologic techniques for pain management?
Besides opioids, what is new in systemic analgesia? NSAIDs, APAP, ketamine, alpha-2 agonists, and butyrophenones are reviewed.
Regional and local anesthesia can avoid the risks of systemic analgesia or procedural sedation, but what are the best agents and additives to use?
What are the easiest and most effective nerve blocks to use for the hands, face, chest, shoulder, and hip?
Pain management through nursing protocols and patient-controlled analgesia are showing promising results – is your ED using them?
What is new in ED management of chronic pain, and what can be done about drug-seeking behavior?
Publication Date: December 1, 2017
CME Expiration Date: December 1, 2020
CME: This enduring material includes 4.5 AMA PRA Category 1 CreditsTM. Included as part of the 4 credits, this CME activity is eligible for 4.5 Pain Management CME credits and 4.5 Trauma CME credits.
Christopher R. Tainter, MD, RDMS
Associate Clinical Professor, Department of Anesthesiology, Division of Critical Care, Department of Emergency Medicine, University of California San Diego, San Diego, CA
Ashika Jain, MD, RDMS
Department of Emergency Medicine and Trauma Critical Care, Kings County Hospital Center, Brooklyn, NY
Monica K. Wattana, MD
Fellow, Emergency Oncology/Pain Management, The University of Texas MD Anderson Cancer Center, Houston, TX
Andy Jagoda, MD, FACEP
Professor and Chair Emeritus, Department of Emergency Medicine; Director, Center for Emergency Medicine Education and Research, Icahn School of Medicine at Mount Sinai, New York, NY
Table of Contents
Critical Appraisal of the Literature
Emergency Department Evaluation
Nonpharmacologic Pain Management
Agents for Systemic Analgesia
Route of Administration for Systemic Analgesia
Frequency of Dosing for Systemic Analgesia
Agents for Regional Anesthesia
Additives for Regional Anesthesia
Intravenous Regional Anesthesia (Bier Block)
Regional Nerve Blocks
Upper Extremity Nerve Block
Femoral Nerve Block
Intercostal Nerve Block
Interscalene Brachial Plexus Block
The Unconscious or Critically Ill Patient
Traumatic Abdominal Pain
Patients With Chronic Pain
Time- and Cost-Effective Strategies
Risk Management Pitfalls for Pain Management in the Emergency Department
Clinical Pathway for Management of Pain in the Emergency Department
Tables and Figures
Table 1. Selected Opioid Analgesic Agents
Table 2. Nonopioid Analgesic Agents and NSAIDs
Table 3. Analgesic Routes of Administration
Table 4. Selected Topical and Local Anesthetic Agents
Table 5. Nerves and Anatomical Areas Amenable to Regional Nerve Blocks