~ It is traditionally held that the first comparative clinical trial was performed in 1747 by Dr. James Lind of the British Royal Navy to identify a treatment for scurvy. Lind evenly assigned 12 scurvy-afflicted sailors to receive cider, vitriol…
Introduction The end stages of life bring a host of challenging symptoms and causes of suffering that may have accumulated with chronic, progressive, life-limiting diseases. The symptoms of pain, dyspnea, fatigue, and loss of mobility accompany emotional states, such as…
Introduction Pain in the critically ill has been historically poorly understood. Only recently has attention and investigation turned toward the issues of pain assessment and treatment in this patient population. The prevalence of poorly treated pain in the critically ill…
Background to this Chapter This chapter is being written at an unprecedented time in the history of the United States. The coronavirus (SARS-CoV2) pandemic has swept across the country. COVID-19 case numbers, hospitalizations, and deaths show non-Hispanic Blacks, American Indians,…
Key Points Pain is challenging to assess in older adults with moderate to severe dementia because of limitations in ability to communicate pain because of cognitive and linguistic impairments. While older adults with mild to moderate dementia may be able…
Introduction The management of pain related to burns presents a clinical challenge for providers given the complex physiology of injury, chronicity of pain, and the related psychological effects. Despite the variability in etiology, pathophysiology, and severity of burn injuries, treatment…
~ Sickle hemoglobin results from a replacement of glutamine with valine at the sixth amino acid position in the b-globin subunit. Molecules of this abnormal hemoglobin polymerize upon deoxygenation into long polymers that physically deform the erythrocyte into the characteristic…
~ The management and treatment of the pain in the emergency department (ED) is unique from that experienced in other medical settings. Not only is pain often acute as opposed to chronic, but it is often unexpected and sudden. In…
Background and Introduction Of the myriad problems that present to the primary care clinician, pain is the most common and arguably the most concerning. Since pain can herald something as serious as a heart attack or as routine as an…
Risk of infection in interventional pain procedures David A. Provenzano, Michael C. Hanes Introduction Infections related to interventional pain procedures and implantable devices vary considerably based on the target location, causative pathogens, anatomic structures involved, collateral damage, and severity. Surgical…