Repeatedly asking patients “Do you want more pain medicine?” and administering additional doses if they said yes helped achieve patient comfort.
How to prescribe pain medicine is a complicated question, and oligoanalgesia is a well-documented problem. In a prospective cohort study, investigators at a single emergency department evaluated the efficacy of the following protocol for improving pain management: patients aged 21 to 64 years requiring parenteral opioids were given 1 mg hydromorphone and then asked, “Do you want more pain medicine?” every 30 minutes. If they answered “yes,” they were given another 1 mg, up to a maximum dose of 4 mg.
Of 207 patients, 99% received satisfactory analgesia at some point during the study. Nine patients (4%) had oxygen saturations <95% and two (1%) had respiratory rates <10 breaths/minute.
Reviewing Author
DisclosuresConsultant/Advisory BoardPortola Pharmaceuticals, Inc.
Speaker’s BureauPeerView Institute for Medical Education
Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals
DisclosuresConsultant/Advisory BoardPortola Pharmaceuticals, Inc.
Speaker’s BureauPeerView Institute for Medical Education
Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals