CRACKCast E194 - Pain Management

This episode of CRACKCast covers Chapter 3 in Rosen’s Emergency Medicine (9th Ed.) – Pain Management. This podcast will give you a solid approach to the basics pain management to use on your next shift!

Core Questions:

1. Define the following terms (Box 3.1):

• Allodynia
• Amnesia/amnestic
• Local anesthesia
• Analgesia
• Hypnotic
• Narcotic
• Nociceptor
• Noxious stimulus
• Opiate
• Opioid
• Pain
• Procedural Sedation
• Sedative

2. Describe a practical approach to stepwise management of pain in the ED.

3. Describe the adult parenteral and oral doses for:

• Morphine
• Hydromorphone
• Fentanyl 

4. Differentiate between opioid side effects and opioid toxicity.

5. How do you manage opioid toxicity?

6. Describe relative safety profiles for the NSAIDS.

7. List the classes of local anesthetics. How do they work?

8. List the toxic doses for each local anesthetic:

• Lidocaine
• Lidocaine with Epi
• Bupivicaine

9. List 5 techniques to reduce pain of injection of local anesthetic.

10. List agents that can be used for topical anesthesia of:

• Intact skin
• Mucous membranes
• Open skin/lacerations 

Wisecracks:

1. What agent can be used as a substitute in cases of anaphylaxis to local anesthetic?

2. Why should you avoid use of the following agents:

• Tramadol
• Demerol

3. How does local anesthetic toxicity present?