Questions about analgesia in emergency patients

[Valerie13]

Hi guys.

I was wondering if you guys can help me out with a question I have.

If you have an emergency patient that has injuries due to trauma (let's say the person was hit by a car), and the person is in pain, are there any contraindications to giving the patient analgesia if you do not really know the severity of the other injuries? For example, the patient could be in shock, in respiratory depression, and dehydrated....and could have internal bleeding (and possible organ damage).

I'm just trying to figure out what the standard protocols are for giving analgesics in emergency patients....

Thanks!!!

Val

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[Skip Intro]

You may want to ask this over in the EM forum, but as I recall from my ER rotation the main concern is masking the pain symptoms with ensuing inability to distinguish symptomatic changes (e.g., in an acute abdomen) and/or putting the patient in an analgesic/euphoric state that makes it harder to distinguish altered level of consciousness resulting from a worsening clinical picture (e.g., in a closed head injury, etc.). Otherwise, adequate pain control is generally a good - no an excellent - thing... just not necessarily in this setting. But, this scenario you describe is still essentially the dominion of the trauma team.

-Skip