[Analgesia for trauma patients in emergency medicine]

Anaesthesist. 2020 Feb;69(2):137-148. doi: 10.1007/s00101-020-00735-4.
[Article in German]

Abstract

Adequate analgesia is one of the most important measures of emergency care in addition to treatment of vital function disorders and, if indicated, should be promptly undertaken; however, a large proportion of emergency patients receive no or only inadequate pain therapy. The numeric rating scale (NRS) is recommended for pain assessment but is not applicable to every group of patients; therefore, vital signs and body language should be included in the assessment. Pain therapy should reduce the NPRS to <5 points. Ketamine and fentanyl, which have an especially rapid onset of action, and also morphine are suitable for analgesia in spontaneously breathing patients. Basic prerequisites for safe and effective analgesia by healthcare professionals are the use of adequate monitoring, the provision of well-defined emergency equipment, and the mastery of emergency procedures. In a structured competence system, paramedics and nursing personnel can perform safe and effective analgesia.

Keywords: Communication; Injury; Pain; Patient monitoring; Patient safety.

MeSH terms

  • Analgesia / methods*
  • Emergency Medical Services / methods
  • Emergency Medicine / methods*
  • Fentanyl
  • Humans
  • Ketamine
  • Pain / drug therapy*
  • Pain Management / methods
  • Pain Measurement
  • Wounds and Injuries*

Substances

  • Ketamine
  • Fentanyl