Pain is Vital in Resuscitation in Trauma

Overview

Journal SICOT J

Publisher EDP Sciences

Specialty Orthopedics

Date 2019 Aug 16

PMID 31414982

Citations 4

Authors

Theodosios Saranteas

Andreas Kostroglou

Dimitrios Anagnostopoulos

Dimitrios Giannoulis

Pantelis Vasiliou

Andreas F Mavrogenis

Affiliations

Soon will be listed here.

Abstract

Implementation of the ATLS algorithm has remarkably improved the resuscitation of trauma patients and has significantly contributed to the systematic management of multi-trauma patients. However, pain remains the most prevalent complaint in trauma patients, and can induce severe complications, further deterioration of health, and death of the patient. Providing appropriate and timely pain management to these patients prompts early healing, reduces stress response, shortens hospital Length of Stay (LOS), diminishes chronic pain, and ultimately reduces morbidity and mortality. Pain has been proposed to be evaluated as the fifth vital sign and be recorded in the vital sign charts in order to emphasize the importance of pain on short- and long-term outcomes of the patients. However, although the quality of pain treatment seems to be improving we believe that pain has been underestimated in trauma. This article aims to provide evidence for the importance of pain in trauma, to support its management in the emergency setting and the acute phase of patients' resuscitation, and to emphasize on the necessity to introduce the letter P (pain) in the ATLS alphabet.

Citing Articles

Trauma Patients and Acute Compartment Syndrome: Is There an Ariadne's Thread That Can Safely Guide the Anesthesiologist/Emergency Physician Out of the Labyrinth?.

Soulioti E, Pertsikapa M, Fyntanidou B, Limnaios P, Sidiropoulou T Medicina (Kaunas). 2024; 60(8).

PMID: 39202560 PMC: 11356385. DOI: 10.3390/medicina60081279.

Pre-Trauma Pain Is the Strongest Predictor of Persistent Enhanced Pain Patterns after Severe Trauma: Results of a Single-Centre Retrospective Study.

Fetz K, Lefering R, Kaske S Medicina (Kaunas). 2023; 59(7).

PMID: 37512138 PMC: 10383629. DOI: 10.3390/medicina59071327.

PERIPHERAL NERVE BLOCKS FOR HIP FRACTURES  IN EMERGENCY MEDICINE.

Simic A, Nesek Adam V, Rosic D, Kocet N, Svetec M, Herceg A Acta Clin Croat. 2022; 61(Suppl 1):78-83.

PMID: 36304813 PMC: 9536168. DOI: 10.20471/acc.2022.61.s1.13.

Orthopaedic cardiac considerations in emergency.

Katsanos S, Saranteas T, Mavrogenis A SICOT J. 2021; 7:E2.

PMID: 34738901 PMC: 8570134. DOI: 10.1051/sicotj/2021051.

References

Desborough J . The stress response to trauma and surgery. Br J Anaesth. 2000; 85(1):109-17. DOI: 10.1093/bja/85.1.109. View

Sirmali M, Turut H, Topcu S, Gulhan E, Yazici U, Kaya S . A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management. Eur J Cardiothorac Surg. 2003; 24(1):133-8. DOI: 10.1016/s1010-7940(03)00256-2. View

Kehlet H, Dahl J . Anaesthesia, surgery, and challenges in postoperative recovery. Lancet. 2003; 362(9399):1921-8. DOI: 10.1016/S0140-6736(03)14966-5. View

Cohen S, Christo P, Moroz L . Pain management in trauma patients. Am J Phys Med Rehabil. 2004; 83(2):142-61. DOI: 10.1097/01.PHM.0000107499.24698.CA. View

Silka P, Roth M, Moreno G, Merrill L, Geiderman J . Pain scores improve analgesic administration patterns for trauma patients in the emergency department. Acad Emerg Med. 2004; 11(3):264-70. DOI: 10.1111/j.1553-2712.2004.tb02207.x. View

Ebrecht M, Hextall J, Kirtley L, Taylor A, Dyson M, Weinman J . Perceived stress and cortisol levels predict speed of wound healing in healthy male adults. Psychoneuroendocrinology. 2004; 29(6):798-809. DOI: 10.1016/S0306-4530(03)00144-6. View

Hassenbusch S, Portenoy R, Cousins M, Buchser E, Deer T, Du Pen S . Polyanalgesic Consensus Conference 2003: an update on the management of pain by intraspinal drug delivery-- report of an expert panel. J Pain Symptom Manage. 2004; 27(6):540-63. DOI: 10.1016/j.jpainsymman.2004.03.001. View

Bulger E, Edwards T, Klotz P, Jurkovich G . Epidural analgesia improves outcome after multiple rib fractures. Surgery. 2004; 136(2):426-30. DOI: 10.1016/j.surg.2004.05.019. View

Stalnikowicz R, Mahamid R, Kaspi S, Brezis M . Undertreatment of acute pain in the emergency department: a challenge. Int J Qual Health Care. 2005; 17(2):173-6. DOI: 10.1093/intqhc/mzi022. View

10.

Glaser R, Kiecolt-Glaser J . Stress-induced immune dysfunction: implications for health. Nat Rev Immunol. 2005; 5(3):243-51. DOI: 10.1038/nri1571. View

11.

Flagel B, Luchette F, Reed R, Esposito T, Davis K, Santaniello J . Half-a-dozen ribs: the breakpoint for mortality. Surgery. 2005; 138(4):717-23. DOI: 10.1016/j.surg.2005.07.022. View

12.

Davidson E, Ginosar Y, Avidan A . Pain management and regional anaesthesia in the trauma patient. Curr Opin Anaesthesiol. 2006; 18(2):169-74. DOI: 10.1097/01.aco.0000162836.71591.93. View

13.

Ritsema T, Kelen G, Pronovost P, Pham J . The national trend in quality of emergency department pain management for long bone fractures. Acad Emerg Med. 2006; 14(2):163-9. DOI: 10.1197/j.aem.2006.08.015. View

14.

Carrier F, Turgeon A, Nicole P, Trepanier C, Fergusson D, Thauvette D . Effect of epidural analgesia in patients with traumatic rib fractures: a systematic review and meta-analysis of randomized controlled trials. Can J Anaesth. 2009; 56(3):230-42. DOI: 10.1007/s12630-009-9052-7. View

15.

Berben S, Meijs T, van Grunsven P, Schoonhoven L, van Achterberg T . Facilitators and barriers in pain management for trauma patients in the chain of emergency care. Injury. 2011; 43(9):1397-402. DOI: 10.1016/j.injury.2011.01.029. View

16.

Brummett C, Hassett A . Pain: more than just a number. Reg Anesth Pain Med. 2011; 36(4):314-6. DOI: 10.1097/AAP.0b013e318217a64b. View

17.

Woo K . Exploring the effects of pain and stress on wound healing. Adv Skin Wound Care. 2012; 25(1):38-44. DOI: 10.1097/01.ASW.0000410689.60105.7d. View

18.

Sharma D, Vavilala M . Perioperative management of adult traumatic brain injury. Anesthesiol Clin. 2012; 30(2):333-46. PMC: 3424485. DOI: 10.1016/j.anclin.2012.04.003. View

19.

Albrecht E, Taffe P, Yersin B, Schoettker P, Decosterd I, Hugli O . Undertreatment of acute pain (oligoanalgesia) and medical practice variation in prehospital analgesia of adult trauma patients: a 10 yr retrospective study. Br J Anaesth. 2012; 110(1):96-106. DOI: 10.1093/bja/aes355. View

20.

Bakkelund K, Sundland E, Moen S, Vangberg G, Mellesmo S, Klepstad P . Undertreatment of pain in the prehospital setting: a comparison between trauma patients and patients with chest pain. Eur J Emerg Med. 2012; 20(6):428-30. DOI: 10.1097/MEJ.0b013e32835c9fa3. View