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104 Arthritis Pediatric: NSAID (e.g. liquid naproxen 10 mg/kg BID) Special cases: n infectious arthritis ruled out with certainty: intra-articular injection of corticosteroid (e.g. methylprednisolone 10–40 mg depending on joint size) n contraindications to NSAIDs and glucocorticoids: short-course acetaminophen (650–1000 mg PO QID) with a mild opioid (e.g. tramadol 25–50 mg PO QID) RHEUMATOID AND JUVENILE RHEUMATOID ARTHRITIS First line: NSAID (e.g. diclofenac 25–50 mg PO TID) Reasonable: n acetaminophen (650–1000 mg PO QID) n acetaminophen (650–1000 mg PO QID) combined with tramadol (25–50 mg PO QID) Pregnancy: n acetaminophen (650–1000 mg PO QID) n prednisone (1 mg/kg PO QD) n <strong>Int</strong>ra-articular corticosteroid injection (if infection is ruled out) is performed at the Massachusetts General Hospital for pregnant patients Pediatric: NSAID (e.g. naproxen 10 mg/kg PO BID) Special cases: n infectious arthritis ruled out with certainty: intra-articular injection of corticosteroid (e.g. methylprednisolone 10–40 mg depending on joint size) n contraindications to NSAIDs and glucocorticoids: short-course acetaminophen with a mild opioid (e.g. tramadol 25–50 mg PO QID) n high risk of GI bleeding: short-course COX-2 selective NSAID therapy (e.g. celecoxib 200 mg PO BID)
References Arthritis 105 1. Man C, Cheung I, Cameron P, et al. Comparison of oral prednisolone/ paracetamol and oral indomethacin/paracetamol combination therapy in the treatment of acute goutlike arthritis: a double-blind, randomized, controlled trial. Ann Emerg Med. 2007;49:678–681. 2. Schlesinger N. Response to application of ice may help differentiate between gouty arthritis and other inflammatory arthritides. J Clin Rheumatol. 2006;12:275–276. 3. Schlesinger N. Management of acute and chronic gouty arthritis: present state-of-the-art. Drugs. 2004;64:2399–2416. 4. Keith MP, Gilliland WR. Updates in the management of gout. Am J Med. 2007;120:221–224. 5. Sutaria S, Katbamna R, Underwood M. Effectiveness of interventions for the treatment of acute and prevention of recurrent gout: a systematic review. Rheumatology (Oxford). 2006;45:1422–1431. 6. Schlesinger N, Schumacher R, Catton M, et al. Colchicine for acute gout. Cochrane Database Syst Rev. 2006(4):CD006190. 7. Schumacher H, Boice J, Daikh D. Randomised double-blind trial of etoricoxib and indomethacin in treatment of acute gouty arthritis. BMJ. 2002;324:1488–1492. 8. Wortmann RL. Recent advances in the management of gout and hyperuricemia. Curr Opin Rheumatol. 2005;17:319–324. 9. Willburger RE, Mysler E, Derbot J, et al. Lumiracoxib 400 mg once daily is comparable to indomethacin 50 mg three times daily for the treatment of acute flares of gout. Rheumatology (Oxford). 2007; 46(7): 1126–1132. 10. Rubin BR, Burton R, Navarra S, et al. Efficacy and safety profile of treatment with etoricoxib 120 mg once daily compared with indomethacin 50 mg three times daily in acute gout: a randomized controlled trial. Arthritis Rheum. 2004;50:598–606. 11. Bresalier RS, Sandler RS, Quan H, et al. Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial. N Engl J Med. 17 2005;352:1092–1102. 12. White WB, West CR, Borer JS, et al. Risk of cardiovascular events in patients receiving celecoxib: a meta-analysis of randomized clinical trials. Am J Cardiol. 1 2007;99:91–98.
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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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42 Geriatric analgesia ULA HWANG AN
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44 Geriatric analgesia physiologic
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46 Geriatric analgesia Analgesic ap
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48 Geriatric analgesia The common e
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50 Geriatric analgesia 12. Hohl C,
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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 114 and 115: 90 Abdominal aortic aneurysm 19. Le
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 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
Page 164 and 165: 140 Burns for moderate-to-severe bu
Page 166 and 167: 142 Burns References 1. Singer AJM,
Page 168 and 169: 144 Burns 30. Patterson DR, Ptacek
Page 170 and 171: 146 Bursitis and periarticular infl
Page 176 and 177: 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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