J Emerg Med
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Review
Emergency pain management: a Canadian Association of Emergency Physicians (CAEP) consensus document.
Pain is the most common presenting complaint heard in Emergency Medicine, yet it is poorly controlled. Evaluation of this pain should be with use of objective pain scales completed by the patient, not relying on physician impression. Treatment modalities available in the Emergency Department, a review of medications and their dosing as well as specifics to pediatric pain management are presented. ⋯ At the writing of the consensus paper, however, no specific ideas were borrowed from any one article. The appended bibliography is suggested reading, selected from the larger literature review. There are to date few controlled multi centre trials in overall pain management that would allow guidelines to be produced.
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Review Comparative Study
Maintenance fluids in prehospital care: crystalloid versus dextrose solutions--is there a difference?
D5W is the maintenance fluid often used in prehospital care when transporting patients with cardiac or central nervous system processes. However, there is evidence that dextrose solutions are potentially harmful, and that suggests isotonic crystalloid solutions are the preferred maintenance fluid in treating emergent patients regardless of their underlying disease. ⋯ Crystalloids do not cause fluid overload when used at maintenance rates and are effective resuscitative agents in managing hypotension. The use of a single crystalloid solution in the prehospital environment would simplify equipment stocking and management protocols, minimize cost, and would not have an adverse impact on patient care.