Dr. Sergey Motov (USA Emergency Medicine) & Dr. David Lyness (UK/IRE Anaesthetics)
Originally put on this website in July 2016 Taken from Dr Motov's work on a CERTA regime. This is published in conjunction with the CERTA concept explanation here. We can all provide superior analgesia by using medication and techniques other than just opioid medications. This is NOT a definitive list and in all cases, local policies and protocols should be followed. Check your local formularies. This is NOT a prescribing guideline - it is for information ONLY. We do not dispute the role of opioids in many spheres of practice, including emergency medicine, ICU and anaesthetics, rather we wish to highlight the pandemic of high opioid and opiate use. There are many medications available to reduce the amount of opioids used. You may find, when considering your analgesia regimes that opioids are not always the best options for emergency pain issues. We would advocate the use of nerve blocks in the first instance to control acute pain, when feasible.
With respect to alternatives listed for non-radicular back pain, it has been brought to our attention that a new study was presented in 2017 which showed that "diazepam has no benefit when added to naproxen vs placebo" in acute low back pain. See here. This document is for review in 2018 - so please contact us if you have anything to add!
FULLSCREEN
References in document below...
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I have collaborated with Dr. Sergey Motov from New York, USA to bring a series of infographs on a great new concept of CERTA pain relief with the hope of reducing opiate use. This is the latest line in thinking about MULTI MODAL pain relief and characterises the ideas behind multiple analgesic combinations to reduce pain, reduce sedation and provide maximal analgesia to patients in acute pain. Part one below describes the MAIN concepts of CERTA. It should be food for thought to all...
Channels, Enzymes, Receptor Targeted Action! Brad Gander in another great infographic, explores the uses of ETCO2 in cardiac arrest, using PQRST!
Student Paramedic Brad Gander has taken a closer look at the signs, symptoms and risk factors of cerebellar infarction in this new and beautiful infogram!
With a focus on their use in a prehospital environment, Matt Green an Enhanced Paramedic in the NHS explores the number needed to treat (NNT) of the most commonly used analgesics and investigates how useful these can be with respect to acute pain...
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