Particularités de la prise en charge des patients douloureux chronique aux urgences
(2022) Douleurs : evaluation - diagnostic - traitement — Vol. 23, n° 1, p. 31-36 (2022)
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- Authors
Galinski, Michel 
- Abstract
- (en) [Particularities of the management of patients with chronic pain in emergency department] Around 30% of patients admitted in Emergency departments have chronic pain (CP). Among these last, 20 to 30% comes to ED for a pain in relation with their usual pain, i.e. 10% of patients in ED. The aim of this article is to highlight this disease that is not well known by emergency physicians although it is frequent and to propose management modalities. This last is limited by 2 factors in this context. First, emergency physicians have a weak knowledge of these diseases, second, time to take care of these patients is limited in ED. CP is now recognized as a disease in its own right and includes 1 subgroup of primary CP and 6, secondary CPs, including cancer pain. It has been present in the ICD-11since 2018. During management, if it is a non-cancerous CP, the strategy is based on the search for elements of decompensation of a therapeutic or psychological nature, or loss of control over pain management. In the case of cancerous CP, a carcinologic emergency must be ruled out and then a search must be made for breakthrough pain or an increase of pain killers need. In conclusion, patient with chronic pain are frequent in ED and 10% of ED patients comes for their usual pain. Given the volume of patients admitted to the emergency room each year, this represents a significant absolute number. Beware of possible causes of worsening chronic pain, especially in cancer patients. Overall it is clear that emergency physicians are not yet familiar with these diseases.
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Citations
Galinski, M., Gil-Jardiné, C., Lemoel, F., Gregoire, C., & Lvovschi, V. (2022). Particularités de la prise en charge des patients douloureux chronique aux urgences. Douleurs : evaluation - diagnostic - traitement, 23(1), 31-36. https://doi.org/10.1016/j.douler.2022.01.001 (Original work published 2022)