Articles: pain-management.
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Pain felt in an amputated limb is quite common. Phantom pain affects the lives of individuals in many ways and can negatively affect the holistic well-being of individuals. Distant Reiki can be used in the management of these problems. ⋯ Distant Reiki has been found to be easy to administer, inexpensive, non-pharmacological, and appropriate for independent nursing practice to be effective in reducing phantom pain levels and increasing holistic well-being in people with limb amputation.
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First aid cooling for burn injuries improves re-epithelialisation rates and reduces scarring. The objective of this research was to explore and describe barriers and facilitators to the provision of optimal first aid for acute burn patients in the prehospital setting. Emergency medical service (EMS) clinicians in Queensland were invited via email to participate in a survey designed to assess experience, knowledge, and attitudes regarding provision of optimal burn first aid in the prehospital setting (N = 4500). ⋯ The most common of these was identified as pain. Similarly, free text responses (n = 276) regarding facilitators of burn first aid formed eight dimensions with 21 subcategories - most commonly fast and effective pain relief. Factors influencing burn first aid provision in the prehospital setting were wide-ranging and varied, with pain identified as the most prominent.
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Emerg Med Australas · Apr 2024
Nine recommendations for the emergency department for patients presenting with low back pain based on management and post-discharge outcomes in an Australian, tertiary emergency department.
To ascertain and develop recommendations for analgesic management, discharge planning and further healthcare utilisation of adults presenting to an Australian tertiary ED with radicular or low back pain (LBP). ⋯ ED presentations for LBP were more often treated pharmacologically than non-pharmacologically, with opioids commonly prescribed and NSAIDs potentially under-utilised. Post-discharge, additional investigations/referrals, discharge analgesia reductions and maintenance of non-pharmacological management were common. Opioid initiation as a result of LBP presentations, signifies a potential 'gateway' towards unintentional long-term use. Key study findings form our nine recommendations to inform ED LBP pain management.
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Analgesic tolerance due to long-term use of morphine remains a challenge for pain management. Morphine acts on μ-opioid receptors and downstream of the phosphatidylinositol 3-kinase signaling pathway to activate the mammalian target of rapamycin (mTOR) pathway. Rheb is an important regulator of growth and cell-cycle progression in the central nervous system owing to its critical role in the activation of mTOR. The hypothesis was that signaling via the GTP-binding protein Rheb in the dorsal horn of the spinal cord is involved in morphine-induced tolerance. ⋯ This study suggests spinal Rheb as a key molecular factor for regulating mammalian target of rapamycin signaling.