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Pain Management in Emergency Department
 

Pain Management in Emergency Department

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Presentation of Dr.Mohamed Adly at Emergency Medicine Update Course, the leading emergency medicine event in Egypt. www.emegypt.org

Presentation of Dr.Mohamed Adly at Emergency Medicine Update Course, the leading emergency medicine event in Egypt. www.emegypt.org

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    Pain Management in Emergency Department Pain Management in Emergency Department Presentation Transcript

    • What we do wrong in EDPain ManagementMohamed AdlyLecturer of Anesthesia, ICU and Pain ManagementNational Cancer Institute, Cairo University
    • Pain is more than a symptom
    • Pain is unpleasant sensory and emotionalexperience associated with actual or potentialtissue damage.
    • AssessmentOnsetCourseDurationSeverityAccompanying symptoms.
    • Assessment• Single dimension:–Verbal, numerical rating scale.–Visual analouge score.• Multidimentional:–McGill pain questionnaire.
    • Pathway• Primary afferent neurones’ cells at DRG.• Secondary afferent neurones’ cells at dorsalhorn.• Lateral spinothalamic tract.• Thalamus.• Somatosensory cortex.
    • • Nociceptors (sensory receptors)• Stimulations:• mechanical• Thermal• chemical
    • Types of pain• Visceral.• Somatic.Or….• Acute.• Chronic:– Neuropathic.– Inflammatory.– Dysfunctional.
    • Analgesics• Simple analgesics:• Paracetamol, NSAIDS, weak opioids e.g. codiene.• Opioids:• Immediate release, sustained release.
    • Modalities• PCA.• Transdermal delivery system.
    • Modalities• Physiotherapy• TENS.• Neuromodulation.• Psychotherapy.
    • Common diseases• Trigeminal neuralgia.• CRPS.• Post-herpetic neuralgia.
    • Back pain• Red flags:– Cauda equina syndrome.– Tumor.– Infection.– Aneurysm.– Fracture.
    • OIN??
    • Thank you