在大规模伤亡事件中,是时候重新考虑止痛药
Timothee de Valence1, Laurent Suppan2
1Division of Anaesthesiology, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland.
Wilderness & environmental medicine
|November 3, 2023
概括
在大规模伤亡事件中,提供疼痛缓解 (止痛) 是至关重要的. 在医院前环境中早期使用安全有效的止痛方法可以改善患者的护理并预防长期问题.
科学领域:
- 紧急医疗 紧急医疗
- 创伤护理 创伤护理
- 疼痛管理 疼痛管理
背景情况:
- 在大规模伤亡事件 (MCI) 中,疼痛管理往往会延迟,导致创伤受害者的结果不佳.
- 不充分的急性疼痛管理可以阻碍疏散,并导致慢性疼痛和创伤后应激障碍 (PTSD).
研究的目的:
- 评估在大规模伤亡事件中实施早期止痛方案的可行性和影响.
- 探索新,安全和简单的止痛方法在医院前MCI环境中的潜力.
主要方法:
- 对MCI止痛药的现行实践的审查.
- 分析新的医院前止痛技术的安全性和有效性.
- 评估这些方法在现有MCI协议中的潜在整合.
主要成果:
- 新的镇痛方法在医院前环境中是安全有效的.
- 这些方法可以很容易地纳入MCI协议.
- 在MCI中早期的止痛药的使用是可以实现和有益的.
结论:
- 在大规模伤亡事件中实施早期止痛是一种改善患者护理的可行策略.
- 采用新的,简单的,安全的疼痛管理技术可以提高创伤受害者在大规模伤亡事件的结果.
- 在MCI中优先考虑镇痛可以减轻慢性疼痛和PTSD的风险.
相关概念视频
Analgesia and Pain Management
634
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...
634
SBAR II: Application of SBAR
4.4K
SBAR is an effective communication tool used by healthcare professionals to communicate patient information accurately. SBAR stands for Situation, Background, Assessment, and Recommendation. For a better understanding, an example is given below.
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
4.4K
Opioid Analgesics: Synthetic and Semisynthetic Opioids
310
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...
310
Local Anesthetics: Clinical Application as Epidural Anesthesia
438
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...
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...
438
Local Anesthetics: Pharmacokinetics
775
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...
775
Cardiopulmonary Resuscitation IV: Pharmacological Management
12
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
12


