EMERGENCY SEDATION AND PAIN MANAGEMENT

1 EMERGENCY SEDATION AND pain MANAGEMENTP rocedural SEDATION and analgesia represents one of the great advances in the anesthesiologist, SEDATION and pain MANAGEMENT proceduresare now a routine partof all EMERGENCY department SEDATION and pain Managementis a comprehensive medical textaddressing EMERGENCY SEDATION and analgesia with specific emphasis on treatment ofthe EMERGENCY department patient. The easily accessible, clinically oriented formatallows the reader fast and efficient access to the key points in each text presents a clinical approach to the treatment of pain in emergencypatients, including pediatric and adult populations.

2 Analgesia, SEDATION , andanesthetic techniques are presented in an informative, authoritative, and conciseformat written and edited by physicians with extensive research as well as clinicalemergency medicine expertise. The chapters are richly supplemented with tables,photographs, and step-by-step h. burton, md, has been the Residency Program Director in EmergencyMedicine and a Professor of EMERGENCY Medicine at Albany Medical College inAlbany, NY, since 2006. From 1999 to 2003, Dr. Burton was the Medical Director forMaine EMERGENCY Medical Services and, from 1995 to 2006, he worked in theDepartment of EMERGENCY Medicine at the Maine Medical Center in Portland.

3 Hewas the founding Research Director in the Department of EMERGENCY Medicine atMaine Medical Burton s areas of research interest are procedural SEDATION and analgesia, EMERGENCY medical services, and MANAGEMENT of cardiovascular emergencies. He haspublished extensively in the EMERGENCY medicine literature on these and relatedtopics. He has received awards and peer recognition throughout his academic careernoting a commitment to the specialty of EMERGENCY Burton completed medical school at the University of North Carolina at ChapelHill in 1992 and residency training at the University of Pittsburgh Affiliated Residencyin EMERGENCY Medicine in miner, md, facep.

4 Has been the Director of Performance Improvementand the Associate Research Director in the Department of EMERGENCY Medicine atHennepin County Medical Center since 1999 and is an Associate Professor ofEmergency Medicine at the University of Minnesota Medical Miner has performed extensive research in the areas of pain MANAGEMENT andprocedural SEDATION in the EMERGENCY Department and has published numerousmanuscripts on these topics. He is an associate editor ofAcademic Miner completed medical school at Mayo Medical School in 1996 and residencytraining at the Hennepin County Medical Center in EMERGENCY Medicine in 1999.

5 Cambridge University University Press978-0-521-87086-3 - EMERGENCY SEDATION and pain ManagementEdited by John H. Burton and James MinerFrontmatterMore informationEmergency Sedationand pain ManagementEdited byJOHN H. BURTONA lbany Medical CollegeJAMES MINERU niversity of Minnesota School of Medicine Cambridge University University Press978-0-521-87086-3 - EMERGENCY SEDATION and pain ManagementEdited by John H. Burton and James MinerFrontmatterMore informationcambridge university pressCambridge, New York, Melbourne, Madrid, Cape Town, Singapore, Sa o Paulo, DelhiCambridge University Press32 Avenue of the Americas, New York, NY 10013-2473, on this title: John H.

6 Burton and James Miner 2008 This publication is in copyright. Subject to statutory exceptionand to the provisions of relevant collective licensing agreements,no reproduction of any part may take place withoutthe written permission of Cambridge University published 2008 Printed in the United States of AmericaA catalog record for this publication is available from the British of Congress Cataloging in Publication DataEmergency SEDATION and pain MANAGEMENT / edited by John H. Burton, James ; bibliographical references and 978-0-521-87086-3 (hardback : alk.)

7 Paper)1. Anesthesia. 2. Analgesia. 3. EMERGENCY medicine. I. Burton, John Miner, James.[DNLM: 1. Analgesia methods. 2. Anesthesia methods. 3. EMERGENCY Service, EMERGENCY Treatment methods. 5. pain therapy. WO 200 E534 2008] dc222007037371 ISBN 978-0-521-87086-3 hardbackEvery effort has been made in preparing this book to provide accurate and up-to-dateinformation that is in accord with accepted standards and practice at the time of , the authors, editors, and publisher can make no warranties that the informationcontained herein is totally free from error, not least because clinical standards are constantlychanging through research and regulation.

8 The authors, editors, and publisher thereforedisclaim all liability for direct or consequential damages resulting from the use of materialcontained in this book. Readers are strongly advised to pay careful attention to informationprovided by the manufacturer of any drugs or equipment that they plan to University Press has no responsibility for the persistence oraccuracy of URLs for external or third-party Internet Web sites referred toin this publication and does not guarantee that any content on suchWeb sites is, or will remain, accurate or appropriate.

9 Cambridge University University Press978-0-521-87086-3 - EMERGENCY SEDATION and pain ManagementEdited by John H. Burton and James MinerFrontmatterMore informationContentsAcknowledgmentspageix List of ContributorsxiSECTION ONE. OVERVIEW AND PRINCIPLES IN EMERGENCYANALGESIA AND PROCEDURAL SEDATION11 EMERGENCY Analgesia PrinciplesJames Miner and John H. Burton12 EMERGENCY Procedural SEDATION PrinciplesJohn H. Burton and James Miner53 Analgesic and Procedural SEDATION Principles Uniqueto the Pediatric EMERGENCY DepartmentSusan Fuchs114 pain and Analgesia in the InfantMichelle P.

10 Tomassi185 Provider Bias and Patient Selection for EmergencyDepartment Procedural SEDATION and AnalgesiaKnox H. Todd256 Federal and Hospital Regulatory Oversight in EmergencyDepartment Procedural SEDATION and AnalgesiaSharon Roy307 Nursing Considerations in EMERGENCY DepartmentProcedural SEDATION and AnalgesiaTania D. Strout and Dawn B. Kendrick38 SECTION TWO. ANALGESIA FOR THE EMERGENCY PATIENT438 Pharmacology of Commonly Utilized Analgesic AgentsEustacia Jo Su439 Patient Assessment: pain Scales and Observation inClinical PracticeTania D.