 | RISK MANAGEMENT AND PATIENT SATISFACTION
Audio-Digest Emergency Medicine
Volume 24, Issue 24
December 21, 2007
Risk, errors, and patient satisfaction – Kevin M. Klauer, DO
What is the best evidence for the management of acute back pain? – Ann P. Nguyen, MD
 Click here to read an abstracted written summary of this program.
Points of Care– Strategies for .. satisfaction: .. never tell patient no need to return to ED; .. patient much less likely to sue .. if patient thinks physician did his or her best; .. patients would rather have ED physician refer them to specialist (than own FP).. encourage patient to ask questions; effective pain management important; .. let patient speak for at least 1 min; explain your impression (not final diagnosis) to patient; .. family members should agree with plan; .. NSAIDs: most commonly prescribed drugs for low back pain; plethora of literature .. statistically significant improved relative risk for decrease in pain, and that NSAIDs did not produce greater adverse effects than placebo; Opioids: 3 studies of opioids .. better than placebo in relieving back pain and improving function .. Steroids: paucity of data .. only one that used intramuscular (IM) steroids for low back pain in ED; only handful of studies on low back pain in ED; Physical interventions: .. back exercises not helpful in relieving acute low back pain but marginally helpful in chronic low back pain; bed rest detrimental to recovery; good evidence that heat better than other interventions, but no data about cold compared to other interventions.
Dr. Klauer at 18th Annual High-Risk Emergency Medicine, Apr 16-17, 2007, in Las Vegas, NV, by the Center for Emergency Medicine Education. Dr. Nguyen at Contemporary Concepts in Clinical Emergency Medicine, June 6-8, 2007, in NY, NY, by the New York Univ Sch of Med, Dept of Em Med.
| |
