Analgesia Medical Directive Question

Submission ID: 1

Question:

 

This question is regarding the indication for the new analgesia medical direction. The new indication is just "pain" with a contraindication of suspected cardiac ischemia. I am aware of plenty of situations where this protocol would be appropriate. Example a fracture extremity or hip, renal colic, acute muscle strain, burns or etc. My main concern is what would be considered an appropriate type of pain to receive our analgesic medication or can we now consider all types of pain appropriate as long as it is not suspected cardiac ischemia?

The protocol/companion document do not mention other types of visceral pain. Can someone with acute/chronic abdominal pain be treated with our analgesic medication? Example appendicitis or pancreatitis.

Does the origin of the pain need to be traumatic in nature? Example a pt has an acute infection in their limb or a possible DVT causing extreme pain.

What about a pt with a possible fractured rib or traumatic neck/back injury?

Headache/migraine?

Answer:


As you have stated, to meet the analgesia medical directives condition, the patient must have ‘pain’. To answer your questions, yes, all types of pain can be considered for the analgesia medical directive if the condition is met and not contraindicated, such as ischemic chest pain.
You have also asked if someone with other types of visceral pain such as abdominal, appendicitis, or pancreatitis meet this directive. The answer is yes.
In summary, it is your clinical evaluation to determine if the patient meets the analgesia medical directive. They don’t strictly need traumatic pain to qualify.
To answer the remainder of your questions, yes a person with traumatic rib, neck, and back injuries qualifies as does someone with a headache or migraine.
If you have a better understanding of the pharmacology of the analgesia medication you can provide including its pharmacokinetics, pharmcodynamics, benefits and adverse effects, this will assist you in making an appropriate treatment plan.

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