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dc.contributor.authorChadkirk, Ralph
dc.date.accessioned2019-09-12T15:36:20Z
dc.date.available2019-09-12T15:36:20Z
dc.date.issued2017-07
dc.identifier.citationChadkirk, R., 2017. Pre-hospital management of pain associated with an acute sickle cell crisis. Journal of Paramedic Practice, 9 (7), 312–315.en_US
dc.identifier.issn1759-1376
dc.identifier.issn2041-9457
dc.identifier.doi10.12968/jpar.2017.9.7.312
dc.identifier.urihttp://hdl.handle.net/20.500.12417/204
dc.description.abstractAbstract published with permission. Sickle Cell Disease and its acute manifestation as a sickle cell crisis has a severely deleterious effect on predicted mortality and quality of life of its sufferers. Serious sequelae can occur, resulting in severe neurological and cardiovascular impairment. In the majority of cases these patients will present to pre-hospital clinicians with acute intractable pain unmanaged by the patient’s own analgesia. Unfortunately, some evidence reports that pain is commonly under-treated with assumptions made about drug-seeking behaviour. The evidence presented in this paper will indicate that Entonox should no longer be routinely used for the management of sickle cell pain. Instead, emphasis should turn to the use of potent intravenous opiates (where intravenous access can be reliably and aseptically gained). The use of diamorphine and ketamine for extreme pain should be investigated by pre-hospital services, as should the use of non-steroidal anti-inflammatory drugs.
dc.language.isoenen_US
dc.subjectEmergency Medical Servicesen_US
dc.subjectPain Managementen_US
dc.subjectSickle Cell Diseaseen_US
dc.subjectAnalgesiaen_US
dc.subjectPharmacy and Pharmacologyen_US
dc.titlePre-hospital management of pain associated with an acute sickle cell crisisen_US
dc.typeJournal Article/Review
dc.source.journaltitleJournal of Paramedic Practiceen_US
dcterms.dateAccepted2019-09-04
rioxxterms.versionNAen_US
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden_US
rioxxterms.licenseref.startdate2019-09-04
refterms.panelUnspecifieden_US
refterms.dateFirstOnline2017-07
html.description.abstractAbstract published with permission. Sickle Cell Disease and its acute manifestation as a sickle cell crisis has a severely deleterious effect on predicted mortality and quality of life of its sufferers. Serious sequelae can occur, resulting in severe neurological and cardiovascular impairment. In the majority of cases these patients will present to pre-hospital clinicians with acute intractable pain unmanaged by the patient’s own analgesia. Unfortunately, some evidence reports that pain is commonly under-treated with assumptions made about drug-seeking behaviour. The evidence presented in this paper will indicate that Entonox should no longer be routinely used for the management of sickle cell pain. Instead, emphasis should turn to the use of potent intravenous opiates (where intravenous access can be reliably and aseptically gained). The use of diamorphine and ketamine for extreme pain should be investigated by pre-hospital services, as should the use of non-steroidal anti-inflammatory drugs.en_US


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