Wilderness and Rescue Medicine 8th Edition

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Section IV: Trauma

Chapter 12 Review: Pain Management

• Pain is both a symptom of a problem and a problem to be treated. • Pain management includes treating the cause of the pain and reducing the perception of pain with the use of medication. • Medications commonly used in pain management include analgesics and anesthetics. • Analgesic classes include NSAIDs like ibuprofen, non-opioid analgesics like acetaminophen, and opioids like morphine. • Benzodiazepines like lorazepam may be used as adjuncts. • Anesthetics like lidocaine inactivate nerve cells, causing temporary numbness. • The goal of pain management in the wilderness and rescue setting is an awake patient with tolerable pain. • Most pain can be managed with NSAIDs or acetaminophen. More severe pain may require the addi- tion of opioids and benzodiazepines. Localized or procedural pain may be managed with anesthetics. • The risks associated with opioid and benzodiazepine use include excessive sedation with respiratory depression, airway obstruction, aspiration, and undetected ischemia. • The risks associated with the use of anesthetics include self-inflicted injury due to loss of pain feedback. • Practitioners should know the legal implications, indications, contraindications, precautions, dosage, route, side effects, and interactions of any medication carried.

The goal of pain management in the wilderness and rescue setting is an awake patient with tolerable pain.