Articles: pain-clinics.
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Rev Esp Anestesiol Reanim · Oct 2012
[A survey on the use of fluoroscopy in the treatment of pain: do we perform it correctly?].
Fluoroscopy is technique that is commonly used for procedures in the treatment of pain, but despite its importance in healthcare, many specialists do not know how to use it. We conducted a national survey to evaluate its use. ⋯ There is a lack of information on the handling of the fluoroscope in the area of pain treatment, and this usually leads to the adoption of insufficient radiation protection measures. The treatments are usually performed in the operating theatre. More than half the specialists perform less 10 procedures per week with x-rays. The control and follow-up of radiation values is insufficient, as is the information and protection offered to the patient.
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A retrospective cohort study. ⋯ Referral to a PTC/SC did not yield improved functional outcomes in this cohort. A major factor contributing to this finding was the length of time to referral to PTC/SC after the initial injury.
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Social science & medicine · Sep 2012
The struggle to improve patient care in the face of professional boundaries.
Professional boundaries make inter-professional communication, collaboration and teamwork more challenging and can jeopardise the provision of safe, high quality patient care. This in-depth interview study conducted in three UK acute hospital organisations in 2003-2004 explored how professional boundaries affected efforts to improve routine practice by acute pain services (small specialist teams set up to drive improvements in postoperative pain management through education, training, standard-setting and audit). The study found that many anaesthetists and to a lesser extent nursing staff saw postoperative pain management as a new and unjustified addition to their professional role. ⋯ The inter-professional boundaries led to the acute pain services devoting a substantial part of their time to performing a 'go-between' function between nurses and doctors. The intra-professional boundaries hindered collaborative working among doctors and limited the influence that the acute pain service nurses could have on improving the practice of other nurses. Further work is needed to address the underlying fears that can lead to resistance around role changes and to develop effective strategies to minimise the impact of professional boundaries on patient care.
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Pain management should be warranted for all children in every situation. Italian legislation proposes a model for pain assistance based on specialized tertiary centers which provide direct clinical management for complex cases and assure continuous cooperation with hospitals and family pediatricians for managing painful conditions every day. The Procedural Pain Service of the University of Padua Department of Pediatrics applies such model for procedural pain management. ⋯ Most frequently administered drug combinations were local analgesia + intravenous midazolam alone or midazolam and propofol or midazolam and propofol and ketamine; most frequently used non-pharmacological methods were distraction using cartoons and bubbles. Minor adverse events were recorded in 281 cases (2.5%), the most common being desaturation (2.1%). In conclusion, our model functions on two integrated levels, and it can be considered generally applicable as a solution for pain management.
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Acta Anaesthesiol Scand · Jul 2012
Post-operative pain treatment in Denmark from 2000 to 2009: a nationwide sequential survey on organizational aspects.
In Denmark, the first acute pain service (APS) was introduced in 1993. An important objective became to facilitate implementation of accelerated post-operative rehabilitation programmes (ACC) in selected procedures in abdominal, gynaecological and orthopaedic surgery. Therefore, it is of considerable interest to study the association between the developments of post-operative pain management and the ACC by sequential analyses from 2000 to 2009. ⋯ The study, spanning nearly a decade, illustrates that following an increase in number of APSs from 2000 to 2006, followed by a significant decline, a steadily increasing number of departments implemented ACC.