Acute Pain Control

Chalk Talk #1: Acute Pain Control

In Chalk Talks by Brent Thoma14 Comments

BoringEM Chalk Talk’s are short (<5 minutes), basic videos aimed at contextualizing preclinical knowledge. They were initially created for the students of the Harvard Medical School Learner-Directed Simulation Program Chalk. I found that similar topics seemed to come up in a lot of the groups that I was teaching. Rather than doing the same basic tutorial for all of them, I decided to do it once and post it here for them to view. If anyone else finds it useful, that’s a cherry on top.

Acute Pain Control

This video was created to provide a basic approach to acute pain control. It discusses oral and intravenous opioids (morphine, fentanyl, hydromorphone and oxycodone) and non-opioids (Acetaminophen and NSAIDS including toradol and naproxen).

Summary

Acute pain can be treated with opioids and non-opioids.

Opioids can be given intravenously or orally. Common intravenous opioids include morphine (2-5mg dose; 20 minute onset, 3-4 hour duration) and fentanyl (~0.75-1mcg/kg dose; 3-5 minute onset, 30 minute duration). Common oral opioids include hydromorphone (2mg tabs) and oxycodone (1-2 tabs; usually combined with non-opioid analgesics). Watch for respiratory depression, hypotension and altered mental status. Be cautious when treating patients with kidney or hepatic failure and with elderly or unstable patients.

Non-opioids include NSAIDs and Acetaminophen. Ketorolac is an NSAID that can be given intravenously (10mg dose; 6h duration) while ibuprofen (400mg dose; 6h duration) and naproxen (500mg dose; 12h duration) are NSAIDs that can be given orally. They should be used carefully in the elderly and generally not given to patients with renal insufficiency or a history of ulcers. Acetaminophen (650-975mg; 6h duration) can also be given orally. It should generally not be given to patients with alcoholism or hepatic failure.

Conclusion

As I’m tentatively planning to make more of these I would appreciate any feedback. Was it useful or am I wasting my time? Should I keep posting them as YouTube videos? Or podcasts? Or both? Would you rather I draw things out Khan Academy-style? Or was the Prezi okay? Thanks!

Brent Thoma

Editor at CanadiEM
Dr. Brent Thoma is a medical educator, blogging geek, and trauma/emergency physician who works at the University of Saskatchewan College of Medicine. He founded BoringEM and is the CEO of CanadiEM.