Pain Management with Dr. Sergey Motov, Part 2

<p><strong>Overview<br /></strong>Do you ever get overwhelmed with all the ED analgesic options? In part 2 on ED Pain Management, Dr. Sergey Motov helps break things down, reviewing a few cases and finishing with <strong>Sergey’s 10 Commandments of ED Pain Management</strong>.</p> <p><strong>Key Points<br /></strong>Sergey's 10 Commandments of ED Pain Management</p> <ol> <li>Titrate opioids regardless of initial dosing regimen: weight-based, fixed, or nurse-initiated.</li> <li>Use alternatives (to IV) routes of analgesic administration: PO, PR, IN, SubQ, nebulized, topical.</li> <li>Utilize sub-dissociative dose ketamine for selected acute and chronic painful conditions.</li> <li>Educate patients about appropriate expectations of pain course and management.</li> <li>Embrace a concept of channels/enzymes/receptors targeted analgesia.</li> <li>Use NSAIDs based on their analgesic ceiling dose.</li> <li>Attempt to use non-opioid analgesics whenever possible.</li> <li>Promote nerve blocks for a variety of acute painful conditions (trauma, infection, inflammation).</li> <li>DO NOT prescribe long-acting opioids, SR/ER opioids, or fentanyl patches in the ED or at discharge.</li> <li>If indicated, DO prescribe a short course of immediate release opioids (preferably morphine sulfate IR) at discharge and arrange proper follow-up.</li> </ol> <p><strong>Resources and References</strong></p> <ol> <li>Cisewski DH, Motov SM. <a href= "https://www.emra.org/books/pain-management/pain-management-table-of-contents/" target="_blank" rel="noopener">EMRA Pain Management Guide</a>. EMRA. Dallas, Texas:2020.<br /> <em style= "font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;"> • App version available within MobilEM at</em> <a style= "font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;" href="https://apps.apple.com/us/app/mobilem/id1474834329?ls=1" target="_blank" rel