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90 Abdominal aortic aneurysm 19. Lee A, Cooper MG, Craig JC, et al. Effects of nonsteroidal anti-inflammatory drugs on postoperative renal function in adults. Cochrane Database Syst Rev. 2000(4):CD002765. 20. Splinter WM, Rhine EJ, Roberts DW, et al. Preoperative ketorolac increases bleeding after tonsillectomy in children. Can J Anaesth. 1996;43:560–563. 21. Fragen RJ, Stulberg SD, Wixson R, et al. Effect of ketorolac tromethamine on bleeding and on requirements for analgesia after total knee arthroplasty. J Bone Joint Surg Am. 1995;77:998–1002. 22. Strom B, Berlin J. Parenteral ketorolac and risk of gastrointestinal and operative site bleeding: a postmarketing surveillance study. JAMA. 1996;275:376–382.
Aortic dissection KALANI OLMSTED AND DEBORAH B. DIERCKS n Agents n Opioids n Beta-blockers n Calcium channel blockers n Vasodilators n Evidence According to panels addressing management of aortic dissection (AD), available levels of evidence rate no higher than “expert opinion.” 1 Hemodynamic (anti-impulse) therapy remains the foundation of AD care, and successful control of blood pressure and heart rate improves patient comfort. However, in most patients with AD, the inability of anti-impulse therapy to control severe pain mandates an early role for aggressive analgesia. 2 The first step in AD care, anti-impulse therapy, serves as optimal medical management and also provides some pain relief. Beta-blockers (e.g. metoprolol, propranolol, esmolol, labetalol) decrease the force of cardiac contraction and reduce blood pressure; both of these properties make this class ideal for minimizing AD progression. 1,3,4 In patients with relative betablocker intolerance, esmolol’s short half-life renders it the best initial choice. 1 Ongoing pain after beta-blocker administration usually indicates incomplete blood pressure control. In such cases, pain relief (and optimal medical management) is facilitated by vasodilation. The traditional choice is sodium nitroprusside. Fenoldopam (a dopamine-1 agonist that selectively dilates arterioles and renal vasculature) may also be used. When AD is accompanied by cardiac ischemia, the calcium channel blocker nicardipine is indicated; reflex tachycardia renders nitroglycerin (glyceryl trinitrate) potentially dangerous as a treatment for chest pain when AD is suspected. 1,3–5 91
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Emergency Department Analgesia An E
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Contents List of contributors page
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Tension-type headache 384 Trigemina
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Michel Galinski, MD Attending Physi
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Benjamin A. White, MD Resident, Har
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xiv Foreword code to light up the p
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xvi Foreword The authors of the boo
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Preface A typical shift in the Emer
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Acknowledgments Many thanks to this
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General considerations
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4 Introduction and general approach
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10 Assessment of pain CATHERINE A.
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12 Assessment of pain n Pain assess
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14 Assessment of pain The Face, Leg
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16 Assessment of pain 3. Silka P, R
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18 Assessment of pain 33. Melzack R
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20 Prehospital analgesia and protoc
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22 Prehospital analgesia prehospita
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24 Prehospital analgesia care provi
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26 Prehospital analgesia EMS settin
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28 Prehospital analgesia 18. Kurtz
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30 Prehospital analgesia 48. Helm M
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32 Epidemiologic overview of ED pai
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Page 64 and 65: 40 Epidemiologic overview of ED pai
Page 66 and 67: 42 Geriatric analgesia ULA HWANG AN
Page 68 and 69: 44 Geriatric analgesia physiologic
Page 70 and 71: 46 Geriatric analgesia Analgesic ap
Page 72 and 73: 48 Geriatric analgesia The common e
Page 74 and 75: 50 Geriatric analgesia 12. Hohl C,
Page 76 and 77: 52 Chronic pain DAVID CLINE AND STE
Page 78 and 79: 54 Chronic pain care providers, it
Page 80 and 81: 56 Chronic pain the agent’s monoa
Page 82 and 83: 58 Chronic pain be in the ED record
Page 84 and 85: 60 Chronic pain 7. Freynhagen R, Bu
Page 86 and 87: 62 NSAIDs and opioids applicable sa
Page 88 and 89: 64 NSAIDs and opioids We believe th
Page 90 and 91: 66 NSAIDs and opioids well-demonstr
Page 92 and 93: 68 NSAIDs and opioids 5. Navascues
Page 94 and 95: 70 Nonstandard medication delivery
Page 102 and 103: 78 Reflections on ED analgesia of u
Page 104 and 105: 80 Reflections on ED analgesia para
Page 106 and 107: 82 Reflections on ED analgesia chem
Page 109: Chief complaints and diagnoses
Page 112 and 113: 88 Abdominal aortic aneurysm occurs
Page 116 and 117: 92 Aortic dissection Citing sedativ
Page 118 and 119: 94 Arthritis TODD M. LISTWA AND STE
Page 120 and 121: 96 Arthritis NSAIDs may be safer th
Page 122 and 123: 98 Arthritis for patients with high
Page 124 and 125: 100 Arthritis rofecoxib, ordiclofen
Page 126 and 127: 102 Arthritis For breakthrough pain
Page 128 and 129: 104 Arthritis Pediatric: NSAID (e.g
Page 130 and 131: 106 Arthritis 13. Hur C, Chan AT, T
Page 132 and 133: 108 Arthritis 38. Curtis SP, Ko AT,
Page 134 and 135: 110 Arthritis 63. Bliddal H, Tersle
Page 136 and 137: 112 Biliary tract pain A retrospect
Page 138 and 139: 114 Biliary tract pain n Summary an
Page 140 and 141: 116 Biliary tract pain 20. Malesci
Page 142 and 143: 118 Bites and stings - marine enven
Page 144 and 145: 120 Bites and stings - marine jelly
Page 146 and 147: 122 Bites and stings - marine 11. C
Page 148 and 149: 124 Bites and stings - terrestrial
Page 158 and 159: 134 Breast pain COX-2 selective NSA
Page 160 and 161: 136 Breast pain Pregnancy: acetamin
Page 162 and 163: 138 Burns JEREMY ACKERMAN AND ADAM
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140 Burns for moderate-to-severe bu
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142 Burns References 1. Singer AJM,
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144 Burns 30. Patterson DR, Ptacek
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146 Bursitis and periarticular infl
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152 Cancer and tumor pain bony (or
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154 Cancer and tumor pain (20 mg ev
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156 Cancer and tumor pain existing
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158 Cancer and tumor pain n Summary
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160 Cancer and tumor pain 21. Carac
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162 Cardiac chest pain KALANI OLMST
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164 Cardiac chest pain has traditio
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166 Cardiac chest pain Practice Gui
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168 Chest wall trauma MICHEL GALINS
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170 Chest wall trauma NSAIDs. As is
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172 Chest wall trauma n Summary and
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174 Chest wall trauma 21. Seltzer J
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176 Chronic low-back pain limited t
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178 Chronic low-back pain n Summary
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180 Cluster headache SOHAN PAREKH A
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182 Cluster headache n Summary and
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184 Corneal abrasion LISA CALDER n
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186 Corneal abrasion 6. Patrone G,
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188 Cystitis, urethritis, and prost
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194 Dysmenorrhea to that achieved w
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196 Dysmenorrhea 12. Fine PG. The r
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198 Endometriosis by 50-74% compare
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200 Esophageal spasm KALANI OLMSTED
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202 Esophageal spasm via central mo
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204 Fibromyalgia MICHAEL WALTA AND
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206 Fibromyalgia A multicenter plac
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208 Fibromyalgia n Summary and reco
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210 Fibromyalgia 15. Sayar K, Aksu
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212 Fibromyalgia 41. Russell IJ, Mi
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214 Gastritis and peptic ulcer dise
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226 Gastroesophageal reflux disease
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232 Hemorrhoids and perianal pain B
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234 Hemorrhoids and perianal pain a
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236 Hemorrhoids and perianal pain t
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238 Hemorrhoids and perianal pain C
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240 Hemorrhoids and perianal pain 9
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242 Hemorrhoids and perianal pain 3
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244 Migraine and undifferentiated h
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254 Mucositis and stomatitis KELLY
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256 Mucositis and stomatitis eviden
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258 Mucositis and stomatitis above)
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260 Mucositis and stomatitis 5. Dem
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262 Mucositis and stomatitis 30. Mu
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264 Neck and back pain - mechanical
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266 Neck and back pain - mechanical
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268 Neck and back pain - radicular
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274 Neck and back pain - spinal spo
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276 Neck and back pain - spinal spo
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278 Neuropathy - complex regional p
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280 Neuropathy - diabetic DAVID CLI
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282 Neuropathy - diabetic n Summary
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284 Neuropathy - diabetic 16. Lesse
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286 Neuropathy - HIV related 3600 m
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288 Neuropathy - HIV related 12. Le
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290 Neuropathy - overview OVER-THE-
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292 Neuropathy - overview The TCAs,
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294 Neuropathy - overview Gabapenti
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296 Neuropathy - overview However,
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298 Neuropathy - overview Reference
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300 Neuropathy - overview 27. Wiffe
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302 Neuropathy - phantom limb pain
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304 Neuropathy - phantom limb pain
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306 Ocular inflammation STEPHEN H.
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308 Ocular inflammation Other RCT d
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310 Ocular inflammation Pregnancy:
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312 Ocular inflammation 20. Frucht-
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314 Odontalgia MICHAEL T. SCHULTZ A
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316 Odontalgia 100 mg caffeine and
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318 Odontalgia TOPICAL THERAPY Topi
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320 Odontalgia 4. Cooper SA, Engel
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322 Odontalgia 32. Sveen OB, Yaekel
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324 Orthopedic extremity trauma inf
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326 Orthopedic extremity trauma The
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328 Orthopedic extremity trauma fem
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330 Orthopedic extremity trauma 35.
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332 Osteoporotic vertebral compress
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334 Osteoporotic vertebral compress
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336 Otitis media and externa benefi
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338 Otitis media and externa 5. Var
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340 Pancreatitis (which lacks effec
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342 Pancreatitis 5. Hubbard GP, Wol
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344 Pharyngitis KELLY YOUNG n Agent
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346 Pharyngitis complete pain relie
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348 Pharyngitis 7. Blagden M, Chris
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350 Pharyngitis 31. Shi Y, Gu R, Li
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352 Postdural puncture headache Cas
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354 Post-herpetic neuralgia JEREMY
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356 Post-herpetic neuralgia virtual
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358 Post-herpetic neuralgia 11. Raj
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360 Renal colic scores. 3 The Cochr
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362 Renal colic References 1. O’C
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364 Sialolithiasis n Summary and re
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366 Sickle cell crisis concluded th
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368 Sickle cell crisis One potentia
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370 Sickle cell crisis titrated in
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372 Sickle cell crisis but acute ca
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374 Sickle cell crisis treatment ti
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376 Sickle cell crisis 3. Dunlop RJ
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378 Sickle cell crisis Disease-rela
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380 Temporomandibular disorders NAT
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382 Temporomandibular disorders n S
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384 Tension-type headache SOHAN PAR
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386 Tension-type headache for TH, b
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388 Tension-type headache 18. Lance
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390 Trigeminal neuralgia as the ini
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392 Undifferentiated abdominal pain
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Tables
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Selected nonsteroidal anti-inflamma
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Selected opioids Maintenance pediat
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Other analgesic drugs Lactation Dos
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Other analgesic drugs (cont.) Lacta
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Other analgesic drugs (cont.) Lacta
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