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A significant proportion of emergency patients are already in pain at initial presentation. In order to minimise sensitisation, pain management should be instituted as soon as possible and, once the pain is under control, the patient kept on a level pain-free plateau. All animals going on to have operative procedures performed will benefit from adequate preoperative analgesia, i.e. in advance of the significant noxious stimulation resulting from surgical intervention. And it is clearly important to bear in mind the onset of action the agent you are using has to prevent noxious stimulation before analgesic efficacy has been achieved.

Emergency pain relief

 

Summary of dose rates, routes of administration and dosing frequencies of opioids in current use in emergency clinics.

Analgesic quiz

 

Click here to test your knowledge on analgesic agents!

MLK preparation

 

The idea behind the use of this multiagent infusion is to provide multimodal analgesia with the inherent benefits that that strategy offers.

Although some institutions use standardised prepared stock solutions of morphine, lidocaine and ketamine (MLK) for convenience, the author prefers to make up the CRI solution on an individual patient basis with the initial concentrations being guided by the patient in question.

NSAID memo

 

Whenever prescribing or administering

non-steroidal anti-inflammatory drugs (NSAIDs), these five points should help guide treatment.

 

... Read more

 

by Shailen Jasani

Analgesia for the emergency/critical care patient –

part 2: Analgesic agents

Volume 26(3), Autumn 2016

Commissioned paper