Port Pirie : Analgesia and Procedural Sedation

Although the relief of acute pain is the most common reason that patients seek emergency care research studies have documented that acute pain is frequently poorly managed. There is often a complete failure to provide any form of analgesia in a timely manner and even when analgesia is provided it is often ineffective due to either poor drug selection, inappropriate route of administration or inadequate dosing. This phenomenon is so significant that it has been given its own name – “Oligoanalgesia”. In the first topic we explore the principles for assessing and treating acute pain and discover the rewards that result from a thoughtful and informed approach to providing pain relief.

In the second topic we examine the topic of "Procedural Sedation". This describes the administration of drugs in a controlled setting to reduce pain and / or awareness. Procedural sedation is used to reduce the pain associated with laceration repair and removal of foreign bodies from the ear or nose in the young child, the reduction and immobilisation of fractures and dislocations and emergency cardioversion of cardiac arrhythmias. The sedative agents most commonly used in procedural sedation are Midazolam +/- Fentanyl, Propofol and Ketamine. This course examines the indications, contraindications for procedural sedation, assessment, monitoring and after care of the patient undergoing procedural sedation and the common drugs used for procedural sedation.

Course Outline

Part 1 : Acute Pain Management

• 1. Core Principles

• 2. Oral analgesics

• 3. Severe pain

Part 2 : Procedural Sedation

• 4. Core Principles

• 5. Midazolam + Fentanyl, Propofol, Ketamine

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