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330 Orthopedic extremity trauma 35. Mahar PJ, Rana JA, Kennedy CS, et al. A randomized clinical trial of oral transmucosal fentanyl citrate versus intravenous morphine sulfate for initial control of pain in children with extremity injuries. Pediatr Emerg Care. 2007;23(8):544–548. 36. Turturro MA, Paris PM, Yealy DM, et al. Hydrocodone versus codeine in acute musculoskeletal pain. Ann Emerg Med. 1991;20(10):1100–1103. 37. Marco CA, Plewa MC, Buderer N, et al. Comparison of oxycodone and hydrocodone for the treatment of acute pain associated with fractures: a doubleblind, randomized, controlled trial. Acad Emerg Med. 2005;12(4):282–288. 38. Hewitt DJ, Todd KH, Xiang J, et al. Tramadol/acetaminophen or hydrocodone/ acetaminophen for the treatment of ankle sprain: a randomized, placebocontrolled trial. Ann Emerg Med. 2007;49(4):468–480, e461–e462.
Osteoporotic vertebral compression fracture SUSAN R. WILCOX AND STEPHEN H. THOMAS n Agents n Acetaminophen n NSAIDs n Opioids n Calcitonin n Pamidronate n Evidence Treatment of osteoporotic vertebral compression fracture (OVCF) is multifaceted, but most techniques (e.g. kyphoplasty, nerve blocks, jacket splints) require orthopedic consultation. For the acute care provider, OVCF pharmacotherapy begins with acetaminophen (paracetamol). 1,2 Although NSAIDs are sometimes a second-line choice, the increased risk of GI and renal complications in the elderly, the population at highest risk for OVCF, renders this class of analgesics less than ideal. 1,3 (Issues relevant to NSAID use and fracture-specific risks are discussed in the chapter on extremity fractures.) Since the pain from OVCF is often too severe for adequate control with relatively weak analgesics such as acetaminophen and NSAIDs, opioids are commonly the next choice. The ability of opioids to alleviate OVCF pain is not doubted, although there is little high-level evidence addressing the subject. The problem, as discussed in the chapter on geriatric analgesia (p. 42), lies with the relatively high complication rates associated with opioid use in the (elderly) population with OVCF. In fact, the relative frequency of opioid-related side effects (e.g. falls, constipation) in OVCF is largely responsible for the exploration of alternative analgesic approaches that is the focus of this chapter. 1–3 Once-daily calcitonin, either IM, PR, SC, or IN may be known to some providers as an outpatient preventative therapy for those at risk of OVCF. 4,5 In terms of its relief of bony pain, calcitonin has had disappointing results in 331
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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
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124 Bites and stings - terrestrial
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134 Breast pain COX-2 selective NSA
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136 Breast pain Pregnancy: acetamin
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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
Page 304 and 305: 280 Neuropathy - diabetic DAVID CLI
Page 306 and 307: 282 Neuropathy - diabetic n Summary
Page 308 and 309: 284 Neuropathy - diabetic 16. Lesse
Page 310 and 311: 286 Neuropathy - HIV related 3600 m
Page 312 and 313: 288 Neuropathy - HIV related 12. Le
Page 314 and 315: 290 Neuropathy - overview OVER-THE-
Page 316 and 317: 292 Neuropathy - overview The TCAs,
Page 318 and 319: 294 Neuropathy - overview Gabapenti
Page 320 and 321: 296 Neuropathy - overview However,
Page 322 and 323: 298 Neuropathy - overview Reference
Page 324 and 325: 300 Neuropathy - overview 27. Wiffe
Page 326 and 327: 302 Neuropathy - phantom limb pain
Page 328 and 329: 304 Neuropathy - phantom limb pain
Page 330 and 331: 306 Ocular inflammation STEPHEN H.
Page 332 and 333: 308 Ocular inflammation Other RCT d
Page 334 and 335: 310 Ocular inflammation Pregnancy:
Page 336 and 337: 312 Ocular inflammation 20. Frucht-
Page 338 and 339: 314 Odontalgia MICHAEL T. SCHULTZ A
Page 340 and 341: 316 Odontalgia 100 mg caffeine and
Page 342 and 343: 318 Odontalgia TOPICAL THERAPY Topi
Page 344 and 345: 320 Odontalgia 4. Cooper SA, Engel
Page 346 and 347: 322 Odontalgia 32. Sveen OB, Yaekel
Page 348 and 349: 324 Orthopedic extremity trauma inf
Page 350 and 351: 326 Orthopedic extremity trauma The
Page 352 and 353: 328 Orthopedic extremity trauma fem
Page 356 and 357: 332 Osteoporotic vertebral compress
Page 358 and 359: 334 Osteoporotic vertebral compress
Page 360 and 361: 336 Otitis media and externa benefi
Page 362 and 363: 338 Otitis media and externa 5. Var
Page 364 and 365: 340 Pancreatitis (which lacks effec
Page 366 and 367: 342 Pancreatitis 5. Hubbard GP, Wol
Page 368 and 369: 344 Pharyngitis KELLY YOUNG n Agent
Page 370 and 371: 346 Pharyngitis complete pain relie
Page 372 and 373: 348 Pharyngitis 7. Blagden M, Chris
Page 374 and 375: 350 Pharyngitis 31. Shi Y, Gu R, Li
Page 376 and 377: 352 Postdural puncture headache Cas
Page 378 and 379: 354 Post-herpetic neuralgia JEREMY
Page 380 and 381: 356 Post-herpetic neuralgia virtual
Page 382 and 383: 358 Post-herpetic neuralgia 11. Raj
Page 384 and 385: 360 Renal colic scores. 3 The Cochr
Page 386 and 387: 362 Renal colic References 1. O’C
Page 388 and 389: 364 Sialolithiasis n Summary and re
Page 390 and 391: 366 Sickle cell crisis concluded th
Page 392 and 393: 368 Sickle cell crisis One potentia
Page 394 and 395: 370 Sickle cell crisis titrated in
Page 396 and 397: 372 Sickle cell crisis but acute ca
Page 398 and 399: 374 Sickle cell crisis treatment ti
Page 400 and 401: 376 Sickle cell crisis 3. Dunlop RJ
Page 402 and 403: 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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