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Related Concept Videos

Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Analgesia and Pain Management01:25

Analgesia and Pain Management

Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

Local Anesthetics: Differential Sensitivity of Nerve Fibers

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Related Experiment Videos

Does emergency department workload adversely influence timely analgesia?

Rob Mitchell1, Anne-Maree Kelly, Debra Kerr

  • 1Monash University, Melbourne, Victoria, Australia.

Emergency Medicine Australasia : EMA
|March 4, 2009
PubMed
Summary

Emergency department (ED) workload did not impact time to analgesia (TTA). However, factors like advanced age, non-English language, and delayed pain assessment were linked to longer TTA for patients with acute pain.

Related Experiment Videos

Area of Science:

  • Emergency Medicine
  • Pain Management
  • Healthcare Operations

Background:

  • Emergency department (ED) overcrowding is a significant concern impacting patient care.
  • The relationship between ED workload and timely pain relief, specifically time to analgesia (TTA), requires further investigation.

Purpose of the Study:

  • To investigate the association between ED workload and TTA in patients experiencing acute pain.
  • To identify factors contributing to delays in analgesia administration.

Main Methods:

  • An observational, retrospective study analyzed 254 adult patients with acute pain (biliary pain, renal colic, fractures) from May 2006 to March 2007.
  • Patients were categorized into workload groups (low, middle, high) based on total patient care time; high workload defined as 85-140% ED occupancy.
  • Cox regression and multivariate analyses were used to compare TTA across workload groups and identify associated factors.

Main Results:

  • No significant association was found between ED workload and TTA (HR 1.02).
  • Factors independently associated with delayed analgesia included advanced age, non-English speaking background, lower triage acuity, and delayed pain assessment.
  • Higher initial pain scores correlated with quicker analgesia administration.

Conclusions:

  • ED workload, as measured by total patient care time, did not significantly influence TTA.
  • Timely pain assessment and patient factors such as age and language are critical determinants of analgesia delay.
  • Strategies to mitigate delays should focus on these identified patient-specific and process-related factors rather than solely on ED volume.