Pain Management in the Emergency Department

急診部門之疼痛處置

蔡明哲(Ming-Che Tsai) ； 陳幸鴻(Hsing-Hong Chen)

《中華民國急救加護醫學會雜誌》 13卷4期 (2002/12) Pp. 139-154

https://doi.org/10.30018/JECCM.200212.0001

摘要

疼痛是急診病人尋求緊急醫療最常見的原因之一。疼痛不僅是健康出問題的警訊，更對身體諸多系統如心臟循環、呼吸、腎功能、血液、新陳代謝及免疫有不良的影響。本文主要論述急診部門對疼痛處置的挑戰，包含了廣泛存在的止痛效果不足的問題，許多衡量疼痛程度的方法，以及各類疼痛處置的優先順位。急診醫師在處理性疼痛的時候常犯種種的謬誤譬如止痛劑的不當選擇，擔心成癮，止痛劑量不足，不當的給藥途徑，不適當的給藥頻率，以及多餘的附加藥劑。我們於文中提供了有關腹痛、腎絞痛、偏頭痛和藥物成者等臨床上常見急診部門的疼痛處置上的建議。

關鍵字

疼痛處置 ； 急診部門

並列摘要

Pain is one the most common reasons why patients seek emergency care. Pain is not only an inherently unhealthy condition, but it also has multiple deleterious effects on cardiovascular, respiratory, renal, hemostatic, metabolic, and immune founctions.
This paper describes the challenges of pain management in the emergency department (ED), including the widespread problem of oligoanalgesia, various techniques of pain measurement, and the competing priorities of pain management. A number of common therapeutic pitfalls await emergency care doctors who manage acute pain, including poor analgesic selection, opio;hobia, analgesic underdosing, improper frequency, and the use of unnecessary opioid adjuncts. Recommenda-tions are made for managing the pain associated with several common clinical problems seen in EDs, including acute abdominal pain, renal colic, migraine headache, and so-called drug-seeking behavior.

並列關鍵字

pain management ； emergency department