Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-27T07:45:08.725Z Has data issue: false hasContentIssue false
  • English
  • Français

Immediate Pain Relief in Disaster Conditions

Published online by Cambridge University Press:  17 February 2017

Wolfgang Dick ,
Rudolf Frey  and
A. Madjidi
Wolfgang Dick
Affiliation:
Institut für Anästhesie derUniversität Mainz, West Germany
Rudolf Frey
Affiliation:
Institut für Anästhesie derUniversität Mainz, West Germany
A. Madjidi
Affiliation:
Institut für Anästhesie derUniversität Mainz, West Germany
Get access Rights & Permissions [Opens in a new window]

Extract

Disaster conditions can be characterized as rare, extraordinary and unpredictable events which threaten, injure or kill many people at the same time. The prime examples are earthquakes, floods, traffic or train accidents with hundreds of victims.

While emergency pain relief measures in a few injured victims can be managed individually and really effectively, the requirement for effective pain relief under disaster conditions is still a problem which is largely unsolved. The primary goal of immediate pain relief is the elimination of pain and anxiety which, in themselves, additionally threaten the elementary body functions.

The ideal analgesic drug for adequate pain relief under disaster conditions: 1) should provide the patient with effective analgesia under severe or moderate pain conditions; 2) should ideally sedate the emergency patient to a certain extent; 3) must be effective within a few minutes after intra-muscular, subcutaneous or intravenous administration; 4) should be sufficiently long-acting to avoid the necessity for re-administration several times; 5) should be applicable by paramedical as well as medical personnel; 6) should not have any depressant side effects on respiration and circulation, particularly under conditions of shock and trauma; and 7) should not require intensive monitoring of the patient. This drug has still to be discovered.

The intramuscular or subcutaneous administration of most drugs cannot be considered as methods of immediate effectiveness because most drugs are slowly absorbed, particularly under conditions of shock and trauma. Although the opiate drugs such as morphine, pethidine, and so forth, are obviously effective analgesics, particularly under conditions of severe pain, they cause respiratory and circulation depression, especially if the patient is suffering from hemorrhagic shock, dyspnea and hypoventilation due to thoracic trauma, and so forth.

Type
Section Three—Definitive Medical Care
Information
Prehospital and Disaster Medicine , Volume 1 , Issue 2 , Summer 1985 , pp. 166 - 168
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1985

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Cirota, N. The long term use of ketamine in subanesthetic doses for the burn patient. S.A.S.A. Congress. Capetown, September 25–28, 1978.Google Scholar
2 Clausen, L, Sinclair, DM, VanHasselt, CH. Intravenous ketamine for postoperative analgesia. South African Med Journ 1975; 49:1437.Google Scholar
3 Clements, JA, Nimmo, WS. Ketamine: Pharmakinetics and analgesic activity in man. J Pharm Pharmacol 1980; 32:418.Google Scholar
4 Corssen, G. The use of ketamine hydrochloride for relief of pain and suffering in disaster situations. Intern Kongress über Katastrophenmedizin. Mainz, September 30-October 3, 1977.Google Scholar
5 Dick, W. Schmerzlinderung – Post-operative Phase, Polytrauma. Symposium über Hypnomidate und Analgetika. Linz, October 18, 1980.Google Scholar
6 Finck, AD, Ngai, SH. A possible mechanism of ketamine – induced analgesia. Anaesthesiology 1979; 51:34.CrossRefGoogle Scholar
7 Ito, Y. Post-operative pain relief with ketamine infusion. Anaesthesia 1974; 29:222.Google Scholar
8 Langrehr, D, Singbartl, G. Die Herz-Kreislaufwirkung von Ketamin; Zuzammenfassung der vorliegenden Befunde. Erlanger Anästhesie-Seminare I, 1977.Google Scholar
9 Parkhouse, J. Postoperative analgesia with ketamine and pethidine. Anaesthesia 1977; 32:285.Google Scholar
10 Sadove, MS, Shulman, M, Hatano, S, et al. Analgesic effects of ketamine administered in subdissociative doses. Anesth Analg Curr Res 1971; 50:452.CrossRefGoogle ScholarPubMed
11 Schmitz, JE, Dick, W. Anforderungen an die medikamentöse Schmerzbekämpfung und Sedierung unter Katastrophenbedin-gungen. Intern Kongress über Katastro-phenmedizin. Mainz, September 30-October 3, 1977.Google Scholar
12 Slogoff, S, Allen, GW, Wessels, JV, et al. Clinical experience with subanesthetic ketamine. Anesth Analg Curr Res 1974; 53:354.Google Scholar
13 Steen, SN, Lippmann, M, Mok, MS. Katamin-“Low Dose” – Dauertropfinfusion zur Allgemeinanästhesie. European Meeting on Intensive Care. Paris, January 24–26, 1980.Google Scholar
14 Zsigmond, EK, Kothary, SP. Kreislaufver-halter bei 60°-Tischkippung unter Diazepam-Ketamin und Placebo-Ketamin Anästhesie im Doppelblindversuch. European Meeting on Intensive Care. Paris, January 24–26, 1980.Google Scholar