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Morphine in ED

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https://www.readbyqxmd.com/read/29761672/emergency-department-administration-of-oxycodone-by-nurses-treating-musculoskeletal-pain-an-observational-prospective
#1
Mansour Khoury, Sigalit Caspi, Ruth Stalnikowics, Elad Peless, Ela Raiizman, Shaden Salameh
BACKGROUND: Acute musculoskeletal pain is one of the most commonly reported symptoms among patients visiting the emergency department (ED). Treatment with over-the-counter pain medications, given by nurses, results in improved pain management and reduces the waiting time to drug administration without significant side effects. Opioid analgesics are extensively used for acute pain in the ED. Compared to morphine, oxycodone has a much more specific pharmacological activity, higher analgesic potential, and more tolerable side effects...
May 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29741660/intravenous-lidocaine-provides-similar-analgesia-to-intravenous-morphine-for-undifferentiated-severe-pain-in-the-emergency-department-a-pilot-unblinded-randomized-controlled-trial
#2
Eben J Clattenburg, Anthony Nguyen, Tina Yoo, Stefan Flores, Christian Hailozian, Derex Louie, Andrew A Herring
Objectives: We compared the analgesic effects of intravenous (IV) lidocaine and IV morphine for the treatment of severe pain in the emergency department (ED). Methods: This was a pilot, unblinded randomized controlled study comparing the efficacy of IV lidocaine vs IV morphine for patients aged ≥18 years with severe pain (numerical rating scale [NRS] ≥ 7). Participants were randomized to receive IV lidocaine (75 mg if <50 kg, 100 mg if 50-100 kg, and 150 mg if >100 kg) over 10 minutes, followed by a 50-minute IV lidocaine infusion of the same dose or provider-chosen dose of morphine...
May 7, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29696126/acute-pain-management-in-emergency-department-low-dose-ketamine-versus-morphine-a-randomized-clinical-trial
#3
Babak Mahshidfar, Mani Mofidi, Maryam Fattahi, Davood Farsi, Peyman Hafezi Moghadam, Saeed Abbasi, Mahdi Rezai
Background: Ketamine, as an opium alternative, has been proposed for pain relief in the emergency department (ED). Objectives: This study was carried out to compare low dose ketamine (LDK) with morphine for pain relief in trauma patients. Methods: In this randomized double-blinded clinical trial, 300 trauma patients from the ED of 2 teaching hospitals in Tehran, Iran were enrolled and randomly divided into 2 equal groups. The 1st group received 0...
December 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29675707/a-rapid-solution-based-method-for-determining-the-affinity-of-heroin-hapten-induced-antibodies-to-heroin-its-metabolites-and-other-opioids
#4
Oscar B Torres, Alexander J Duval, Agnieszka Sulima, Joshua F G Antoline, Arthur E Jacobson, Kenner C Rice, Carl R Alving, Gary R Matyas
We describe for the first time a method that utilizes microscale thermophoresis (MST) technology to determine polyclonal antibody affinities to small molecules. Using a novel type of heterologous MST, we have accurately measured a solution-based binding affinity of serum antibodies to heroin which was previously impossible with other currently available methods. Moreover, this mismatch approach (i.e., using a cross-reactive hapten tracer) has never been reported in the literature. When compared with equilibrium dialysis combined with ultra-performance liquid chromatography/tandem mass spectrometry (ED-UPLC/MS/MS), this novel MST method yields similar binding affinity values for polyclonal antibodies to the major heroin metabolites 6-AM and morphine...
April 19, 2018: Analytical and Bioanalytical Chemistry
https://www.readbyqxmd.com/read/29675049/administration-of-intravenous-morphine-for-acute-pain-in-the-emergency-department-inflicts-an-economic-burden-in-europe
#5
Montserrat Casamayor, Karen DiDonato, Marc Hennebert, Luca Brazzi, Gregor Prosen
Background: Acute pain is among the leading causes of referral to the emergency department (ED) in industrialized countries. Its management mainly depends on intensity. Moderate-to-severe pain is treated with intravenous (IV) administered opioids, of which morphine is the most commonly used in the ED. We have estimated the burden of IV administration of morphine in the five key European countries (EU5) using a micro-costing approach. Scope: A structured literature review was conducted to identify clinical guidelines for acute pain management in EU5 and clinical studies conducted in the ED setting...
2018: Drugs in Context
https://www.readbyqxmd.com/read/29602664/rate-of-patients-at-elevated-risk-of-opioid-overdose-visiting-the-emergency-department
#6
Justin Ray Pedigo, Charles F Seifert
OBJECTIVE: To determine the rate of patients visiting the emergency department who are at risk of opioid overdose. METHODS: The electronic records of a 412 bed tertiary care county teaching hospital were searched for emergency department (ED) visits from January 1, 2013 to October 31, 2016 to find patients on at least 100mg morphine equivalents (MME) of oral opioid therapy, or an opioid in combination with a benzodiazepine. Records were also searched for patients with a positive urinalysis for opioids when no opioid was present on their home medication list...
March 22, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29581138/acupuncture-in-the-emergency-department-a-systematic-review-of-randomised-controlled-trials
#7
Kwan Leung Chia, Rex Pui Kin Lam, Chung Kwun Lam, Sik Hon Tsui
INTRODUCTION: A comprehensive review of both English and Chinese language literature to inform acupuncture practice in emergency department (ED) settings is lacking. Accordingly, we aimed to conduct a systematic review of English and Chinese randomised controlled trials (RCTs) of acupuncture use in the ED. METHODS: Four English databases (Embase, PubMed, AMED and CENTRAL) and two Chinese databases (CNKI and Wanfang) were systematically searched using the keywords 'acupuncture' and 'emergency department', followed by a bibliographic search of references...
March 26, 2018: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
https://www.readbyqxmd.com/read/29498155/effect-of-a-data-driven-intervention-on-opioid-prescribing-intensity-among-emergency-department-providers-a-randomized-controlled-trial
#8
Sean S Michael, Kavita M Babu, Christopher Androski, Martin A Reznek
OBJECTIVE: Little is known about accuracy of provider self-perception of opioid prescribing. We hypothesized that an intervention asking emergency department (ED) providers to self-identify their opioid prescribing practices compared to group norms-and subsequently providing them with their actual prescribing data-would alter future prescribing compared to controls. METHODS: This was a prospective, multicenter randomized trial in which all attending physicians, residents, and advanced practice providers at four EDs were randomly assigned either to no intervention or to a brief data-driven intervention during which providers were: 1) asked to self-identify and explicitly report to research staff their perceived opioid prescribing in comparison to their peers and 2) then given their actual data with peer group norms for comparison...
March 2, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29484686/predictors-of-gabapentin-overuse-with-or-without-concomitant-opioids-in-a-commercially-insured-u-s-population
#9
Alyssa M Peckham, Kirk E Evoy, Jordan R Covvey, Leslie Ochs, Kathleen A Fairman, David A Sclar
OBJECTIVE: Research suggests the medical consequences of gabapentin overuse depend on whether gabapentin is abused alone or with opioids to potentiate an opioid "high." The objective of this study was to assess predictors of gabapentin overuse with or without concomitant opioids. METHODS: Data were obtained from the Truven Health MarketScan® Commercial Claims and Encounters database for 2013 through 2015. Eligibility criteria were gabapentin utilization, with or without opioids, for 120 days or longer throughout a 12-month observation period...
April 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29483783/acupuncture-versus-titrated-morphine-in-acute-renal-colic-a-randomized-controlled-trial
#10
Kaouthar Beltaief, Mohamed Habib Grissa, Mohamed Amine Msolli, Nasri Bzeouich, Nizar Fredj, Adel Sakma, Hamdi Boubaker, Wahid Bouida, Riadh Boukef, Semir Nouira
Objective: The objective of this study was to compare the analgesic effect and tolerance profile of acupuncture versus intravenous (IV) titrated morphine in patients presenting to the emergency department (ED) with renal colic. Materials and methods: A total of 115 patients were randomized into two groups. Patients in the IV titrated-morphine group (n=61) received 0.1 mg/kg morphine every 5 minutes until pain score dropped by at least 50% of its baseline value. Patients in the acupuncture group (n=54) received an acupuncture session of 30 minutes following a prespecified protocol...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29395284/safety-and-efficacy-of-intravenous-lidocaine-for-pain-management-in-the-emergency-department-a-systematic-review
#11
REVIEW
Lucas Oliveira J E Silva, Kristin Scherber, Daniel Cabrera, Sergey Motov, Patricia J Erwin, Colin P West, M Hassan Murad, M Fernanda Bellolio
STUDY OBJECTIVE: We evaluate the safety and efficacy of intravenous lidocaine in adult patients with acute and chronic pain who are undergoing pain management in the emergency department (ED). METHODS: We searched Ovid CENTRAL, Ovid EMBASE, and Ovid MEDLINE databases for randomized controlled trials and observational studies from inception to January 2017. Efficacy outcomes included reduction in pain scores from baseline to postintervention and need for rescue analgesia...
January 29, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29379807/efficacy-and-safety-of-morphine-and-low-dose-ketamine-for-pain-control-of-patients-with-long-bone-fractures-a-randomized-double-blind-clinical-trial
#12
Fatemeh Jahanian, Seyed Mohammad Hosseininejad, Hamed Amini Ahidashti, Farzad Bozorgi, Iraj Goli Khatir, Seyyed Hosein Montazar, Vahideh Azarfar
Objective: To compare the effects of intravenous morphine and a low dose of ketamine on pain intensity of patients with traumatic fractures of the long bones. Methods: This randomized, controlled, double-blinded, clinical trial was conducted in the adult emergency department (ED) of Emam Khomeini hospital, a tertiary general hospital affiliated with Mazandaran University of Medical Sciences, in Northern Iran, during a 6-month period. Patients were randomly assigned to receive intravenous morphine (0...
January 2018: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/29373155/emergency-department-contribution-to-the-prescription-opioid-epidemic
#13
Sarah Axeen, Seth A Seabury, Michael Menchine
STUDY OBJECTIVE: We characterize the relative contribution of emergency departments (EDs) to national opioid prescribing, estimate trends in opioid prescribing by site of care (ED, office-based, and inpatient), and examine whether higher-risk opioid users receive a disproportionate quantity of their opioids from ED settings. METHODS: This was a retrospective analysis of the nationally representative Medical Expenditure Panel Survey from 1996 to 2012. Individuals younger than 18 years and with malignancy diagnoses were excluded...
January 10, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29371005/perception-and-practice-among-emergency-medicine-health-care-providers-regarding-discharging-patients-after-opioid-administration
#14
Ryan M Surmaitis, Alexandra Amaducci, Kathryn Henry, Michael Jong, Emily A Kiernan, Hope Kincaid, Lindsay J Houck, Sandra J Sabbatini, Marna Rayl Greenberg, Kenneth D Katz
PURPOSE: This study aimed to determine the current attitudes, perceptions, and practices of emergency medicine providers and nurses (RNs) regarding the discharge of adult patients from the emergency department (ED) after administration of opioid analgesics. METHODS: A cross-sectional survey was administered at 3 hospital sites with a combined annual ED census of >180,000 visits per year. All 59 attending emergency physicians (EPs), 233 RNs, and 23 advanced practice clinicians (APCs) who worked at these sites were eligible to participate...
February 2018: Clinical Therapeutics
https://www.readbyqxmd.com/read/29289751/patient-selection-for-total-pancreatectomy-with-islet-autotransplantation-in-the-surgical-management-of-chronic-pancreatitis
#15
Katherine A Morgan, William P Lancaster, Stefanie M Owczarski, Hongjun Wang, Jeffrey Borckardt, David B Adams
BACKGROUND: Best practice to select patients with chronic pancreatitis for surgical management with total pancreatectomy with islet autotransplantation (TPIAT) is in evolution as new discoveries are made in the pathogenesis of chronic pancreatitis. STUDY DESIGN: A prospectively maintained database of patients undergoing TPIAT was reviewed. Islet function was inferred from daily insulin requirement. Pain relief was evaluated by healthcare use and narcotic use. Quality of life (QOL) was measured with the RAND 12-Item Short Form Survey...
April 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29248333/effect-of-automated-prescription-drug-monitoring-program-queries-on-emergency-department-opioid-prescribing
#16
Benjamin C Sun, Christina J Charlesworth, Nicoleta Lupulescu-Mann, Jenny I Young, Hyunjee Kim, Daniel M Hartung, Richard A Deyo, K John McConnell
STUDY OBJECTIVE: We assess whether an automated prescription drug monitoring program intervention in emergency department (ED) settings is associated with reductions in opioid prescribing and quantities. METHODS: We performed a retrospective cohort study of ED visits by Medicaid beneficiaries. We assessed the staggered implementation (pre-post) of automated prescription drug monitoring program queries at 86 EDs in Washington State from January 1, 2013, to September 30, 2015...
March 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29205811/prehospital-analgesic-choice-in-injured-patients-does-not-impact-on-rates-of-vomiting-experience-from-a-new-south-wales-primary-retrieval-service
#17
Michael Zhang, Timothy Cowan, John-Paul Smiles, Mary Morgan, Jessica Armstrong, Chinky Goswami, Claire Sewell
OBJECTIVE: This study aimed to explore the analgesic regimes adopted in our contemporary retrieval practice and the incidence of vomiting in ED after prehospital analgesic use. METHOD: A retrospective review was conducted on trauma patients retrieved by the Hunter Primary Retrieval Service in the Hunter New England Local Health District, New South Wales, Australia, during 2015. RESULTS: Of the 379 patients attended by the service in 2015, 196 of them (mean age 38...
December 4, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29200140/evaluating-the-implementation-barriers-of-an-intranasal-fentanyl-pain-pathway-for-pediatric-long-bone-fractures
#18
Tamara Arnautovic, Kathryn Sommese, Paul C Mullan, Steven Barron Frazier, Turaj Vazifedan, Dana Erikson Ramirez
OBJECTIVES: This study aimed to assess physician comfort, knowledge, and implementation barriers regarding the use of intranasal fentanyl (INF) for pain management in patients with long-bone fractures in a pediatric emergency department (ED) with an INF pain pathway. METHODS: A retrospective chart review was conducted of patients, 3 to 21 years old, in our ED with an International Classification of Diseases-9th Revision code for a long-bone fracture from September 1, 2013, to August 31, 2015...
December 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29170340/43-management-of-acute-low-back-pain-in-the-ed-a-systematic-review
#19
Jane Ashbrook, Nikos Rodgdakis, Peter Goodwin, Gill Yeowell, Michael Callaghan
STUDY OBJECTIVE: There is no consensus on the management of low back pain in the ED and evidence suggests that these patients are likely to receive unwarranted imaging and inappropriate opioid prescription.The purpose of this study is to review the available literature pertaining to the clinical management of acute low back pain in the ED. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) guidelines were observed during this review...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29168404/impact-of-a-chronic-pain-management-pathway-on-opioid-administration-and-prescribing-in-an-emergency-department
#20
Caroline Pace, Sneha Shah, Amy X Zhang, Amy E Zosel
CONTEXT: Prescription opioid abuse and misuse is a significant public health crisis. In 2012, an opioid prescribing pathway for patients with chronic pain presenting to the Emergency Department (ED) was implemented. The objective of this study is to determine the impact of the pathway for administration of opioids in the ED as well as the prescribing of opioids for home use after discharge. METHODS: Retrospective pre- and post-intervention time series study of consecutive patients presenting to the ED with acute and chronic pain complaints before and after implementation of the pathway...
November 23, 2017: Clinical Toxicology
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