GEMC:Emergency Pharmacology / Pain Management

General

This the main page for the Global Emergency Medicine Curriculum Project's Emergency Pharmacology / Pain Management section. For point of care treatment information see the respective category page and non-GEMC notes.

Blood Thinners: Anticoagulants / Antiplatelet Agents

Blogs & Websites

• Bruins Slot KMH, Berge E. Factor Xa inhibitors versus vitamin K antagonists for preventing cerebral or systemic embolism in patients with atrial fibrillation. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD008980. DOI: 10.1002/14651858.CD008980.pub2. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008980.pub2/pdf/standard
• Cochrane summary http://summaries.cochrane.org/CD008980/comparison-of-two-types-of-blood-thinning-drugs-for-preventing-blood-clots-in-people-with-atrial-fibrillation

Acute Pain Management

Book Chapters - Not Open Access

• Miner JR,Burton J. Pain Management. In: Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Mosby/Elsevier; 2010.
  
• Ducharme J. Acute Pain Management.In:Tintinalli JE,Stapczynski SJ,Cline DM, et al., eds. Tintinalli's Emergency Medicine:A Comprehensive Study Guide.8th ed. Mc-Graw-Hill, LLC; 2011
  
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Journal Articles - Open Access

• Borczuk P. AnEvidence-Based Approach To The Evaluation And Treatment Of Low Back Pain In The Emergency Department. Emergency Medicine Practice, Vol.15(7; July 2013. ../docss/AP2_2013.pdf (Accessed on 9/2/13
  
• Lipp C,Dhaliwal R,Lang E.Analgesia in the emergency department:a GRADE-based evaluation of research evidence and recommendations for practice.Critical Care 2013, 17:212 http://ccforum.com/content/17/2/212 (Accessed on 9/21/13)

Blogs and Websites

• American College of Emergency Physicians Clinical Policy: Critical Issues in the Prescribing of Opioids for Adult Patients in the Emergency Department https://www.acep.org/Clinical---Practice-Management/Clinical-Policy--Critical-Issues-in-the-Prescribing-of-Opioids-for-Adult-Patients-in-the-Emergency-Department/
• Paging Goldilocks to the ER: Acute Pain Management in the Emergency Department, Part I. http://empharmd.blogspot.com/2013/08/paging-goldilocks-to-er-acute-pain.html?m=1
  
• Scott Weingart. Patient Controlled Analgesia for Acute Pain. http://emcrit.org/podcasts/gentile-pain/
  

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Podcasts

• Ed Gentile. Patient Controlled Analgesia. http://emcrit.org/podcasts/gentile-pain/
  

Videos

• Fixed hydromorphone protocol effective for emergency pain management.http://www.youtube.com/watch?v=ceUd0bSmsAE 7/14/2011
  

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Chronic Pain Management

Book Chapters - Not Open Access

• Cline DM. Adults with Chronic Pain. In: Tintinalli JE, Stapczynski SJ, Cline DM, et al., eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide.8th ed. McGraw-Hill, LLC; 2011
  

Journal Articles - Open Access

• Manchikanti L, Abdi S, Atluri S, et al.; American Society of Interventional Pain Physicians. American Society of Interventional Pain Physicians (ASIPP) guidelines for responsible opioid prescribing in chronic non-cancer pain: Part 2 -- guidance. Pain Physician. 2012 Jul;15(3 Suppl):S67-116. http://www.painphysicianjournal.com/linkout_vw.php?issn=1533-3159&vol=15&page=S67 Accessed August 2013.

Blogs and Websites

• William Jantsch. The insanity of pain management in the ER. http://www.kevinmd.com/blog/2012/12/insanity-pain-management-er.html
  

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Podcasts

• Minh Le Cong. ED chronic pain management. http://prehospitalmed.com/2012/08/03/pharm-podcast-31-ed-chronic-pain-management/
  
• Suzanne E. Johnson. Pain Care in the ED. EM: RAP 2012 (requires subscription). http://www.emrap.org/episode/2012/january/paincareintheed?link=tag-pain
  
• Rob Orman. The "Oxy Free" ED. EM:RAP 2011. (requires subscription). http://www.emrap.org/episode/2011/march/theoxyfreeed?link=tag-pain
  
• Jim Ducharme. Chronic Pain - A Response to "Oxy Free ED". EM:RAP 2011 (requires subscription). http://www.emrap.org/episode/2011/july/chronicpain?link=tag-pain
  

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Pediatric Pain Management

Book Chapters - Not Open Access

• Young KD, Pediatric Emergency Medicine. In: Baren JM, Rothrock SG, Brennan JA, et al., eds. Pediatric Emergency Medicine.
  
• Auerbach PS.Pain Management and Procedural Sedation in Infant and Children. In:Tintinalli JE,Stapczynski SJ,Cline DM, et al., eds. Tintinalli's Emergency Medicine:A Comprehensive Study Guide.8th ed. Mc-Graw-Hill, LLC; 2011
  

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Podcasts

• Ilene Claudius. Ouchless ED. EM:RAP 2011. (requires subscription) http://www.emrap.org/episode/2011/november/ouchlessed?link=tag-pain
  

Videos

• Kim M. Continuum of Acute Pain Management in Children: Pre-Hospital, Emergency Department, Outpatient http://videos.med.wisc.edu/videos/13650
  

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Geriatric Pain Management

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Videos

• CampER: Acute and Chronic Pain Management in the Elderly. http://www.youtube.com/watch?v=8HbmQ_l0nAk
  
• Lovenvirth W. Pain in the Elderly. http://www.youtube.com/watch?v=u0NuPrtUeCA

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Aberrant Drug-Related Behaviors in the ED

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Policies & Guidelines

• Definition of Addiction. American Society of Addiction Medicine. http://www.asam.org/research-treatment/definition-of-addiction. Accessed August 2013.

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Videos

• Typical Drug Seeking ER Patient. http://www.youtube.com/watch?v=_qkZ8vfxZYI
  
• A Pain Patient's (aka "drug-seeker") ER Adventure! http://www.youtube.com/watch?v=coVJHxmYcwY

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Pharmacology of Pain

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Blogs and Websites

• Chris Bond. NSAIDs Part 1: Which one is best? SOCMOB, 2013. http://socmob.org/2013/02/nsaids-part-1-which-one-is-best/
• Chris Bond. NSAIDs part 2: The Ceiling Effect. SOCMOB 2013. http://socmob.org/2013/02/nsaids-part-2-the-ceiling-effect/
  
• Chris Bond. NSAIDs Part 3: Gastrointestinal Side Effects and Toxicity. SOCMOB 2013. http://socmob.org/2013/03/nsaids-part-3-side-effects-and-toxicity/
  
• SOCMOB. Propofol for Migraine Headache. SOCMOB 2013. http://socmob.org/2013/07/propofol-for-migraine-headache/
  

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Podcasts

• Stuart Swadron. Propofol Abuse. EM:RAP 2012. (requires subscription) http://www.emrap.org/episode/2012/january/propofolabuse?link=episode-segment
  

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Problems and Controversies of Pain Management

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Videos

• ED Sing-a-Long:The Pain Scale Song. http://www.youtube.com/watch?v=DdGqtvAvUVE
  

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Procedures in Pain Management

Book Chapters - Not Open Access

• Burbulys DB, Procedural Sedation and Analgesia. In: Marx JA, Hockberger RS, Walls RM, et al., eds.Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Mosby/Elsevier; 2010.
  
• Schindlbeck MA. Local Anesthesia. In: Reichman EF. Emergency Medicine Procedures. 2nd ed. McGraw-Hill Professional Publishing; 2013.
  
• Schroeder ED, Taillac P. Topical Anesthesia. In: Reichman EF. Emergency Medicine Procedures. 2nd ed. McGraw-Hill Professional Publishing; 2013.
  
• Graham TP. Hematoma Block. In: Reichman EF. Emergency Medicine Procedures. 2nd ed. McGraw-Hill Professional Publishing; 2013.
  
• Reichman EF, MeerJ, Seth N. Regional Nerve Blocks. In: Reichman EF. Emergency Medicine Procedures. 2nd ed. McGraw-Hill Professional Publishing; 2013.
  
• Freeman C. Intravenous Regional Anesthesia. In: Reichman EF. Emergency Medicine Procedures. 2nd ed. McGraw-Hill Professional Publishing; 2013.
  
• Muniz A. Nitrous Oxide Anesthesia. In: Reichman EF. Emergency Medicine Procedures. 2nd ed. McGraw-Hill Professional Publishing; 2013.
  
• Dillon DC, Gibbs MA. Local and Regional Anesthesia.In:Tintinalli JE,Stapczynski SJ,Cline DM, et al., eds. Tintinalli's Emergency Medicine:A Comprehensive Study Guide.8th ed. Mc-Graw-Hill, LLC; 2011
• Weaver C, Beckman AW. Procedural Sedation in Adults.In:Tintinalli JE,Stapczynski SJ,Cline DM, et al., eds. Tintinalli's Emergency Medicine:A Comprehensive Study Guide.8th ed. Mc-Graw-Hill, LLC; 2011
• McGee DL,Local and Topical Anesthesia.In: Roberts JR, Hedges JR. Clinical Procedures in Emergency Medicine: Expert Consult - Online and Print, 6th ed. Saunders, 2013.
• Amsterdam JT, Kilgore KP, Regional Anesthesia of the Head and Neck.In: Roberts JR, Hedges JR. Clinical Procedures in Emergency Medicine: Expert Consult - Online and Print, 6th ed. Saunders, 2013.
• Spektor M,Kelly JJ, Nerve Blocks of the Thorax and Extremities. In: Roberts JR, Hedges JR. Clinical Procedures in Emergency Medicine: Expert Consult - Online and Print, 6th ed. Saunders, 2013.
• Roberts JR, Carney SK, Intravenous Regional Anesthesia. In: Roberts JR, Hedges JR. Clinical Procedures in Emergency Medicine: Expert Consult - Online and Print, 6th ed. Saunders, 2013.
• Krauss B, Green SM, Systemic Analgesia and Sedation for Procedures. In: Roberts JR, Hedges JR. Clinical Procedures in Emergency Medicine: Expert Consult - Online and Print, 6th ed. Saunders, 2013.

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Pain Management Guidelines

Pain Management Protocols

• American College of Emergency Physicians Clinical Policy: Critical Issues in the Prescribing of Opioids for Adult Patients in the Emergency Department https://www.acep.org/Clinical---Practice-Management/Clinical-Policy--Critical-Issues-in-the-Prescribing-of-Opioids-for-Adult-Patients-in-the-Emergency-Department/

See Also

• GEMC: Global Emergency Medicine Curriculum (Main)

Authors

Sergey Motov, Joe Lex, Ross Donaldson, Michael Holtz, Daniel Ostermayer