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Housestaff Survival Guide | Crosscover | Pain
On the phone:
Ask for complete vitals; Try to get a good history on the phone.
Is this pain new?
Where is this pain located?
If this is a new complaint, or worsening complaint, go and assess the patient
Your goal is to a) asses s for any underlying issue that needs to be treated and b) control pain
Diagnosis
When evaluating patient, use a standardized scale to assess the level of pain and for subsequent assessments. If you are evaluating a sickle
cell patient, it is likely that this px knows her baseline pain level or where it was earlier during the day.
Management
Schedule pain meds – then write patient may refuse, or hold if sedated
NSAIDs are good for musculoskeletal pain, pleuritic pain, gout
Avoid NSAIDS if:
pt has renal insufficiency, is anticoagulated, low platelets, h/o active PUD or GI bleed, CHF (can
cause sodium retention), has ASA sensitivity/bronchospasm/nasal polyps, caution with ACE/ARBs
Quick Links
• Acute chest syndrome
• Chest pain
• Abdominal pain
• Pain medication converter