Book contents
- Frontmatter
- Contents
- Acknowledgments
- List of Contributors
- SECTION ONE OVERVIEW AND PRINCIPLES IN EMERGENCY ANALGESIA AND PROCEDURAL SEDATION
- SECTION TWO ANALGESIA FOR THE EMERGENCY PATIENT
- 8 Pharmacology of Commonly Utilized Analgesic Agents
- 9 Patient Assessment: Pain Scales and Observation in Clinical Practice
- 10 Pathways and Protocols for the Triage Patient with Acute Pain
- 11 Patients with Acute Pain: Patient Expectations and Desired Outcomes
- 12 Analgesia for the Adult and Pediatric Multitrauma Patient
- 13 Analgesia for the Emergency Department Isolated Orthopedic Extremity Trauma Patient
- 14 Analgesia for Selected Emergency Eye and Ear Patients
- 15 Analgesia for the Emergency Headache Patient
- 16 Analgesia for the Emergency Chest Pain Patient
- 17 Analgesia for the Emergency Back Pain Patient
- 18 Analgesia for the Acute Abdomen Patient
- 19 Analgesia for the Renal Colic Patient
- 20 Analgesia for the Biliary Colic Patient
- 21 Analgesia for the Chronic Pain Patient
- 22 Outpatient Analgesia following Acute Musculoskeletal Injury
- SECTION THREE PROCEDURAL SEDATION FOR THE EMERGENCY PATIENT
- SECTION FOUR TOPICAL, LOCAL, AND REGIONAL ANESTHESIA APPROACH TO THE EMERGENCY PATIENT
- SECTION FIVE SPECIAL CONSIDERATIONS FOR EMERGENCY PROCEDURAL SEDATION AND ANALGESIA
- Index
- Plate section
- References
10 - Pathways and Protocols for the Triage Patient with Acute Pain
from SECTION TWO - ANALGESIA FOR THE EMERGENCY PATIENT
Published online by Cambridge University Press: 03 December 2009
- Frontmatter
- Contents
- Acknowledgments
- List of Contributors
- SECTION ONE OVERVIEW AND PRINCIPLES IN EMERGENCY ANALGESIA AND PROCEDURAL SEDATION
- SECTION TWO ANALGESIA FOR THE EMERGENCY PATIENT
- 8 Pharmacology of Commonly Utilized Analgesic Agents
- 9 Patient Assessment: Pain Scales and Observation in Clinical Practice
- 10 Pathways and Protocols for the Triage Patient with Acute Pain
- 11 Patients with Acute Pain: Patient Expectations and Desired Outcomes
- 12 Analgesia for the Adult and Pediatric Multitrauma Patient
- 13 Analgesia for the Emergency Department Isolated Orthopedic Extremity Trauma Patient
- 14 Analgesia for Selected Emergency Eye and Ear Patients
- 15 Analgesia for the Emergency Headache Patient
- 16 Analgesia for the Emergency Chest Pain Patient
- 17 Analgesia for the Emergency Back Pain Patient
- 18 Analgesia for the Acute Abdomen Patient
- 19 Analgesia for the Renal Colic Patient
- 20 Analgesia for the Biliary Colic Patient
- 21 Analgesia for the Chronic Pain Patient
- 22 Outpatient Analgesia following Acute Musculoskeletal Injury
- SECTION THREE PROCEDURAL SEDATION FOR THE EMERGENCY PATIENT
- SECTION FOUR TOPICAL, LOCAL, AND REGIONAL ANESTHESIA APPROACH TO THE EMERGENCY PATIENT
- SECTION FIVE SPECIAL CONSIDERATIONS FOR EMERGENCY PROCEDURAL SEDATION AND ANALGESIA
- Index
- Plate section
- References
Summary
SCOPE OF THE PROBLEM
Emergency departments (EDs) face many challenges. Recent data suggest that patient visits in United States EDs have increased 18% over the past 10 years and are now estimated to approximate 110 million visits annually. Pain is the most common symptom in which patients present to the ED. Up to 78% of all patients present to the ED with a chief complaint of pain.
Emergency providers have an important opportunity to intervene with analgesic agents at triage to provide analgesia to patients suffering pain. To affect this scheme, there is a need for nurse-driven analgesic protocols at triage.
Overcrowding
ED crowding has recently been recognized as a critical problem by the Institute of Medicine. A national survey of eight EDs reported experiencing overcrowding 12–73% of the time (mean = 35%). A direct consequence of ED overcrowding is a prolonged time to evaluation by a physician.
Variability at individual institutions is common, and data from a prospective study conducted at a single site reports an average time to initial analgesic of 74 min. Time to pain assessment is also affected by ED overcrowding. Elderly patients with hip fractures have been described as experiencing significantly longer time to pain assessment when the ED is at capacity.
Delays associated with overcrowding leave many patients in the waiting room after the initial triage assessment by a nurse. Patients with pain are forced to wait for physician evaluation and potential pain relief.
- Type
- Chapter
- Information
- Emergency Sedation and Pain Management , pp. 67 - 74Publisher: Cambridge University PressPrint publication year: 2008