Emergency medicine pain management can be painful, but it doesn’t have to be. I recently finished a year-long emergency medicine–focused pain management fellowship, the first of its kind. I had the privilege of working with a variety of subspecialties in an effort to gain their perspectives on acute and chronic pain management.
Explore This IssueACEP Now: Vol 35 – No 04 – April 2016
As emergency physicians, our skills go far beyond Tylenol, Percocet, and Motrin. The problem is we get set in our ways and there is only so much time in the month to stay up to date. I have the answer. Join the newly formed ACEP Pain Management Section, a place where high-yield, cutting-edge pain management information can be made available, right at your fingertips.
We can locate a patient’s internal jugular vein on ultrasound. Why not move the probe over a few centimeters and instead inject local anesthetic around the brachial plexus? We are very comfortable pushing ketamine as an induction agent for intubation. Why not reduce the dose and give it for severe pain or chronic regional pain syndrome in lieu of opiates? It can even be given intranasally!
The Pain Management Section will serve as a venue to discuss relevant pain management topics such as multimodal nonopiate analgesia as well as novel and evidence-based approaches for the management of chronic pain and opiate addiction. The section will keep the College and its members up to date on cutting-edge pain management issues. Additionally, we will collaborate with the Ultrasound, Pediatrics, Geriatrics, and Palliative Care sections, as well as others in the College, to address controversial issues and help elevate pain management knowledge and practice.
In the current political climate, where opiates are a hot issue and compensation is directly related to patient satisfaction and pain relief, emergency physicians are caught in a bind. We are torn between traditional pain management modalities, concerns about not feeding addiction, and the desire to relieve pain. These are some of the issues the Pain Management Section will address.
Pain management does not have to be the unique province of a few fellowship-trained physicians. We all treat pain every day, but we can do it better by incorporating new medications and modalities and applying them in innovative ways. Our patients and our specialty will benefit enormously from these advances in our practice.
I invite you to join me and become part of this new and practice-changing section.
Dr. LaPietra is medical director of emergency medicine pain management and fellowship director of the emergency medicine pain management fellowship at St. Joseph‘s Regional Medical Center in Paterson, New Jersey.
Two New Sections Join ACEP
The ACEP Board of Directors approved two new sections at the January meeting: Pain Management and Event Medicine.
The sections each drew the necessary 100 signatures and were quickly approved by the Board.
The Pain Management Section is designed to promote the subspecialty of pain management; evaluate and develop strategies to better manage acute and chronic pain in the emergency department, including finding ways to treat without opiates; provide discussion of novel protocols and current evidence regarding pain management in ED; and investigate whether to develop an ED-based pain management program.
The section also will advise ACEP on pain management issues, according to the prospective section goals outlined in the new section petition.
The Event Medicine Section aims to train current and future emergency physicians who will act as medical directors and practicing physicians during mass gathering events, according to the section’s petition.
The section plans to develop standard operating procedures for event medicine; study the science behind limited-resource medicine, such as evaluating heat index complications, the type of event, and ratio of physicians and health care providers to spectators or participants; and legal implications for health practitioners.