please discuss about pain management in emergency department.
I work in ED at truma center in Iran as a Nurse and really need a concise protocole to handle with patient with pain. please feel free to discuss about it.
Protocols for pain management is a tricky thing in the ER, in my opinion. You have so many diverse views on pain control from physicians, even in just one group of physicians at one ER. In my ER, for example, we have a few docs that hand out Dilaudid to everyone to a doc that I have seen give morphine MAYBE five times total. As far as giving NSAIDS such as Tylenol or Toradol, we are allowed to give that, unless of course someone is a possible GI bleed. I think, as ER nurses, we are much safer legally trying non-pharm measures until the MD assesses the pt. Have I given pain meds before an MD assesses the pt? Yes. Do I do it often? No. I've only done that if the pt is obviously in horrible pain and I know he will not be seen right away. Even then, it's only been when there's an MD I know will trust me to order that.
I'm curious to see how other facilities work though, for sure.
typical "routine" pain protocols are not used here in the us in the emergency department setting and are physician driven. narcotic usage is strictly monitored by the dea (drug enforcement agency) and the fda (food and drug administration) with accountability for every drop of narcotic administered, wasted, or not used.