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Pain (Principles/MEDs/Comfort Care), Emergency Medicine

Vincent Bounes Reviewed 06/2017
 


Basics

Description

Unpleasant sensory and emotional experience that may be secondary to actual or perceived damage to tissue, the somatosensory system, or a psychogenic dysfunction. 
  • It is an individual...

Diagnosis

Signs and Symptoms

History

  • A patient's self-report is the most reliable measure of pain.

  • Obtain a detailed description of pain:

    • Onset

    • If caused by an injury, determine the mechanism of injury

    • Loca...

Treatment

Pre-Hospital

  • Nonpharmacologic measures are effective in providing pain relief in a pre-hospital setting.

  • Nitrous oxide is an effective analgesic agent in pre-hospital situations.

  • Morphine, fent...

Follow-Up

Disposition

Admission Criteria

Disposition determined by medical condition and persistence of pain. 
  • Medical condition requiring admission.

  • Uncontrolled pain.

Discharge Criteria

  • Medical condition(...

Pearls and Pitfalls

  • In case of severe pain, initiate pain relief simultaneously with the primary assessment.

  • Regular assessment of pain leads to improved pain management.

  • Nonpharmacologic measures are e...

Additional Reading

  • Albrecht  E, Taffe  P, Yersin  B, et al. Undertreatment of acute pain (oligoanalgesia) and medical practice variation in prehospital analgesia of adult trauma patients: A 10 yr retr...

Codes

ICD9

  • 338.19 Other acute pain

  • 338.29 Other chronic pain

  • 780.96 Generalized pain

  • 729.2 Neuralgia, neuritis, and radiculitis, unspecified

  • 307.80 Psychogenic pain, site unspecified

  • 729.1 Myalgia and myosi...

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