ED management : the monthly update on emergency department management
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Patients who visit the ED frequently to obtain treatment for chronic pain can be frustrating and difficult to manage, but some EDs are making progress with this group by linking these patients to resources and establishing a firm policy on when narcotics will be prescribed. Experts say that while strict "no opioids" policies rarely work well, some patients can be helped when given access to more comprehensive treatment approaches. The ED at Methodist Hospital in Indianapolis has developed a multidisciplinary program that includes referrals to a primary care provider (PCP), as well as a chemical dependency specialist. ⋯ The hospital will help to link patients with a PCP and other resources in the region. The approach has curbed the incidence of drug-seeking behavior and helped to make the treatment of chronic pain uniform across all ED providers. Since the prevalence of pain is so high among patients in the ED, many emergency physicians are seeking added training in the treatment of pain.
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A visit to the ED represents a vital opportunity for victims of human trafficking to break free from their exploiters, but this opportunity is often lost, either because ED personnel don't recognize the subtle cues that a person may be a trafficking victim, or because they don't know how to handle the situation. However, resources and training are available to help ED managers raise awareness of the issue in their settings. ⋯ When you suspect that patients may be human-trafficking victims, it is important to speak with them alone so that they are free to explain their situation. However, unless they are a minor, it is their decision on whether to seek help.