Acute Traumatic Pain Management in the ED (Pain Management CME)
Acute Traumatic Pain Management in the Emergency Department (Pain Management CME)(Trauma CME)
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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?

Product Details

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
Peer Reviewers
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

Course Director

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

  1. Abstract
  2. Case Presentations
  3. Introduction
  4. Critical Appraisal of the Literature
  5. Pathophysiology
  6. Prehospital Care
  7. Emergency Department Evaluation
  8. Diagnostic Studies
  9. Treatment
    1. Nonpharmacologic Pain Management
    2. Systemic Analgesia
      1. Agents for Systemic Analgesia
        • Opioid Analgesics
        • Nonopioid Analgesics
        • Dissociatives
        • Alpha-2 Agonists
        • Butyrophenones
      2. Route of Administration for Systemic Analgesia
      3. Frequency of Dosing for Systemic Analgesia
    3. Regional Anesthesia
      1. Agents for Regional Anesthesia
      2. Additives for Regional Anesthesia
    4. Topical Anesthesia/Analgesia
      1. Local Infiltration
        • Hematoma Block
      2. Intravenous Regional Anesthesia (Bier Block)
      3. Regional Nerve Blocks
        • Digital Block
        • Upper Extremity Nerve Block
        • Femoral Nerve Block
        • Intercostal Nerve Block
        • Interscalene Brachial Plexus Block
        • Dental Anesthesia
  10. Special Circumstances
    1. The Unconscious or Critically Ill Patient
    2. Traumatic Abdominal Pain
    3. Pediatric Patients
    4. Geriatric Patients
    5. Drug-Seeking Behavior
    6. Patients With Chronic Pain
  11. Disposition
  12. Summary
  13. Time- and Cost-Effective Strategies
  14. Case Conclusions
  15. Risk Management Pitfalls for Pain Management in the Emergency Department
  16. Clinical Pathway for Management of Pain in the Emergency Department
  17. Tables and Figures
    1. Table 1. Selected Opioid Analgesic Agents
    2. Table 2. Nonopioid Analgesic Agents and NSAIDs
    3. Table 3. Analgesic Routes of Administration
    4. Table 4. Selected Topical and Local Anesthetic Agents
    5. Table 5. Nerves and Anatomical Areas Amenable to Regional Nerve Blocks
    6. Figure 1. Pathophysiology of Pain
    7. Figure 2. Hematoma Block
    8. Figure 3. Intravenous Regional Anesthesia (Bier Block)
    9. Figure 4. Digital Blocks
    10. Figure 5. Femoral Nerve Block
    11. Figure 6. Interscalene Brachial Plexus Block
    12. Figure 7. Apical Periosteal Block
    13. Figure 8. Inferior Alveolar Nerve Block
  18. Videos
  19. References

Product Reviews
Maggie F, NP - 09/07/2018
Great piece! Very informative!
- 03/16/2018
I enjoy the links to demonstrations of regional anesthesia techniques.
- 02/01/2018
Sheer awesomeness
- 01/30/2018
I found it very helpful, especially the links to the video demonstrations.
- 01/30/2018
Excellent article - I did a nerve block for a hip fracture after reading this article.
- 01/30/2018
excellent review article. I appreciated the emphasis on regional analgesia and alternate pain-management techniques
- 01/30/2018
Outstanding article - good mix of pharm, non-pharm, and procedural medicine.
- 01/30/2018
This is a very important topic and one that improves our patient's perception of care.
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