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174 Chest wall trauma 21. Seltzer JL, Larijani GE, Goldberg ME, et al. Intrapleural bupivacaine: a kinetic and dynamic evaluation. Anesthesiology. 1987;67(5):798–800. 22. Mackersie RC, Shackford SR, Hoyt DB, et al. Continuous epidural fentanyl analgesia: ventilatory function improvement with routine use in treatment of blunt chest injury. J Trauma. 1987;27(11):1207–1212. 23. Bulger EM, Edwards T, Klotz P, et al. Epidural analgesia improves outcome after multiple rib fractures. Surgery. 2004;136(2):426–430. 24. Dittmann M, Keller R, Wolff G. A rationale for epidural analgesia in the treatment of multiple rib fractures. Intensive Care Med. 1978;4(4):193–197. 25. Haenel JB, Moore FA, Moore EE, et al. Extrapleural bupivacaine for amelioration of multiple rib fracture pain. J Trauma. 1995;38(1):22–27. 26. Richardson J, Lonnqvist PA. Thoracic paravertebral block. Br J Anaesth. 1998;81(2):230–238. 27. Lonnqvist PA, MacKenzie J, Soni AK, et al. Paravertebral blockade. Failure rate and complications. Anaesthesia. 1995;50(9):813–815.
Chronic low-back pain DAVID CLINE n Agents n Opioids n NSAIDs n Muscle relaxants n Cyclic antidepressants n Evidence Therapy for low-back pain (LBP) that is chronic (CLBP) differs in many respects from the approach to acute back pain. In the nonpharmacologic arena, for instance, there is much better evidence supporting exercise for CLBP than there is for its use in acute back disorders. 1 This chapter focuses on the pharmacological approaches to CLBP (defined as back pain lasting for at least three months). For optimal application of the evidence addressing drug therapy of CLBP, acute care providers should adhere to the general approach for patients with chronic pain as outlined in other chapters. One of the most important tenets is that any therapy prescribed for CLBP should be part of a longitudinal care plan that includes appropriate follow-up and monitoring for both efficacy and safety. In CLBP, one of the major issues for the ED caregiver is use of opioids. The proportion of patients with CLBP who are prescribed opioids ranges widely – from 3% to 66% depending on the setting. 2 As outlined in other chapters in this text, there is a potential role for opioids in acute flares of spine pain (e.g. spinal spondylitic syndromes), but the use of opioids for other neck and back conditions (e.g. radicular syndromes) is not supported by available evidence. Meta-analysis overviewing 38 studies initially, with nine high-quality investigations included in the final calculations, found only a very limited role for opioids in CLBP. 2 If opioids do have a role in this condition, it is 175
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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
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54 Chronic pain care providers, it
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56 Chronic pain the agent’s monoa
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58 Chronic pain be in the ED record
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60 Chronic pain 7. Freynhagen R, Bu
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62 NSAIDs and opioids applicable sa
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64 NSAIDs and opioids We believe th
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66 NSAIDs and opioids well-demonstr
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68 NSAIDs and opioids 5. Navascues
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70 Nonstandard medication delivery
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78 Reflections on ED analgesia of u
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80 Reflections on ED analgesia para
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82 Reflections on ED analgesia chem
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Chief complaints and diagnoses
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88 Abdominal aortic aneurysm occurs
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90 Abdominal aortic aneurysm 19. Le
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92 Aortic dissection Citing sedativ
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94 Arthritis TODD M. LISTWA AND STE
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96 Arthritis NSAIDs may be safer th
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98 Arthritis for patients with high
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100 Arthritis rofecoxib, ordiclofen
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102 Arthritis For breakthrough pain
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104 Arthritis Pediatric: NSAID (e.g
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106 Arthritis 13. Hur C, Chan AT, T
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108 Arthritis 38. Curtis SP, Ko AT,
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110 Arthritis 63. Bliddal H, Tersle
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112 Biliary tract pain A retrospect
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114 Biliary tract pain n Summary an
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116 Biliary tract pain 20. Malesci
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118 Bites and stings - marine enven
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120 Bites and stings - marine jelly
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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
Page 178 and 179: 154 Cancer and tumor pain (20 mg ev
Page 180 and 181: 156 Cancer and tumor pain existing
Page 182 and 183: 158 Cancer and tumor pain n Summary
Page 184 and 185: 160 Cancer and tumor pain 21. Carac
Page 186 and 187: 162 Cardiac chest pain KALANI OLMST
Page 188 and 189: 164 Cardiac chest pain has traditio
Page 190 and 191: 166 Cardiac chest pain Practice Gui
Page 192 and 193: 168 Chest wall trauma MICHEL GALINS
Page 194 and 195: 170 Chest wall trauma NSAIDs. As is
Page 196 and 197: 172 Chest wall trauma n Summary and
Page 200 and 201: 176 Chronic low-back pain limited t
Page 202 and 203: 178 Chronic low-back pain n Summary
Page 204 and 205: 180 Cluster headache SOHAN PAREKH A
Page 206 and 207: 182 Cluster headache n Summary and
Page 208 and 209: 184 Corneal abrasion LISA CALDER n
Page 210 and 211: 186 Corneal abrasion 6. Patrone G,
Page 212 and 213: 188 Cystitis, urethritis, and prost
Page 218 and 219: 194 Dysmenorrhea to that achieved w
Page 220 and 221: 196 Dysmenorrhea 12. Fine PG. The r
Page 222 and 223: 198 Endometriosis by 50-74% compare
Page 224 and 225: 200 Esophageal spasm KALANI OLMSTED
Page 226 and 227: 202 Esophageal spasm via central mo
Page 228 and 229: 204 Fibromyalgia MICHAEL WALTA AND
Page 230 and 231: 206 Fibromyalgia A multicenter plac
Page 232 and 233: 208 Fibromyalgia n Summary and reco
Page 234 and 235: 210 Fibromyalgia 15. Sayar K, Aksu
Page 236 and 237: 212 Fibromyalgia 41. Russell IJ, Mi
Page 238 and 239: 214 Gastritis and peptic ulcer dise
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224 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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