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Emergency department management of acute pain episodes in sickle cell disease.

Publication ,  Journal Article
Tanabe, P; Myers, R; Zosel, A; Brice, J; Ansari, AH; Evans, J; Martinovich, Z; Todd, KH; Paice, JA
Published in: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
May 2007

To characterize the initial management of patients with sickle cell disease and an acute pain episode, to compare these practices with the American Pain Society Guideline for the Management of Acute and Chronic Pain in Sickle-Cell Disease in the emergency department, and to identify factors associated with a delay in receiving an initial analgesic.This was a multicenter retrospective design. Consecutive patients with an emergency department visit in 2004 for an acute pain episode related to sickle cell disease were included. Exclusion criteria included age younger than 18 years. A structured medical record review was used to abstract data, including the following outcome variables: analgesic agent and dose, route, and time to administration of initial analgesic. Additional variables included demographics, triage level, intravenous access, and study site. Mann-Whitney U test or Kruskal-Wallis test and multivariate regression were used to identify differences in time to receiving an initial analgesic between groups.There were 612 patient visits, with 159 unique patients. Median time to administration of an initial analgesic was 90 minutes (25th to 75th interquartile range, 54-159 minutes). During 87% of visits, patients received the recommended agent (morphine or hydromorphone); 92% received the recommended dose, and 55% received the drug by the recommended route (intravenously or subcutaneously). Longer times to administration occurred in female patients (mean difference, 21 minutes; 95% confidence interval = 7 to 36 minutes; p = 0.003) and patients assigned triage level 3, 4, or 5 versus 1 or 2 (mean difference, 45 minutes; 95% confidence interval = 29 to 61 minutes; p = 0.00). Patients from study sites 1 and 2 also experienced longer delays.Patients with an acute painful episode related to sickle cell disease experienced significant delays to administration of an initial analgesic.

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Published In

Academic emergency medicine : official journal of the Society for Academic Emergency Medicine

DOI

EISSN

1553-2712

ISSN

1069-6563

Publication Date

May 2007

Volume

14

Issue

5

Start / End Page

419 / 425

Related Subject Headings

  • United States
  • Statistics, Nonparametric
  • Retrospective Studies
  • Regression Analysis
  • Pain Measurement
  • Pain
  • Middle Aged
  • Male
  • Humans
  • Female
 

Citation

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ICMJE
MLA
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Tanabe, P., Myers, R., Zosel, A., Brice, J., Ansari, A. H., Evans, J., … Paice, J. A. (2007). Emergency department management of acute pain episodes in sickle cell disease. Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, 14(5), 419–425. https://doi.org/10.1197/j.aem.2006.11.033
Tanabe, Paula, Randall Myers, Amy Zosel, Jane Brice, Altaf H. Ansari, Julia Evans, Zoran Martinovich, Knox H. Todd, and Judith A. Paice. “Emergency department management of acute pain episodes in sickle cell disease.Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine 14, no. 5 (May 2007): 419–25. https://doi.org/10.1197/j.aem.2006.11.033.
Tanabe P, Myers R, Zosel A, Brice J, Ansari AH, Evans J, et al. Emergency department management of acute pain episodes in sickle cell disease. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 2007 May;14(5):419–25.
Tanabe, Paula, et al. “Emergency department management of acute pain episodes in sickle cell disease.Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, vol. 14, no. 5, May 2007, pp. 419–25. Epmc, doi:10.1197/j.aem.2006.11.033.
Tanabe P, Myers R, Zosel A, Brice J, Ansari AH, Evans J, Martinovich Z, Todd KH, Paice JA. Emergency department management of acute pain episodes in sickle cell disease. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 2007 May;14(5):419–425.
Journal cover image

Published In

Academic emergency medicine : official journal of the Society for Academic Emergency Medicine

DOI

EISSN

1553-2712

ISSN

1069-6563

Publication Date

May 2007

Volume

14

Issue

5

Start / End Page

419 / 425

Related Subject Headings

  • United States
  • Statistics, Nonparametric
  • Retrospective Studies
  • Regression Analysis
  • Pain Measurement
  • Pain
  • Middle Aged
  • Male
  • Humans
  • Female