Linda Papa

By Linda Papa

Part of the book: Proteomics

By Ivan Samcam MD and Linda Papa MD, MSc

The most common presenting complaint to the emergency department (emergency room) is pain. Unfortunately, pain is still undertreated in this setting. Literature has shown that treatment of pain not only improves patient satisfaction but also improves mood, decreases length of hospital stay, and decreases mortality. Various pharmacological options are available for treating acute pain, ranging from oral, intravenous, and intramuscular medications; topical agents; and peripheral nerve blocks. Objectively assessing and documenting a patient’s pain is the key to determining treatment. The approach to a patient with acute pain requires an experienced clinician who is aware of the pharmacology of analgesics and anesthetics, contraindications, precautions, side effects, administration methods, and monitoring requirements.

Part of the book: Pain Management

By Linda Papa and Kimberly Rosenthal

The diagnosis of acute brain injury in the acute care setting is based on neurological examination and neuroimaging tools such as computed tomography (CT) scanning and magnetic resonance imaging (MRI). However, there are limitations to both CT and MRI scanning. The lack of objective, noninvasive and readily accessible clinical tools to detect injury has left clinicians with uncertainty about how to best identify and treat these conditions. It is also very difficult for patients and their families who struggle to better understand the deficits they deal with on a daily basis. There have been many studies exploring many promising biomarkers during the last decade. Despite the large number of published studies there is still a lack of any Food and Drug Administration (FDA)-approved biomarkers for brain injury in adults and children. Given all of these researches, there is now an important need to validate and introduce them into the clinical setting. This chapter reviews commonly studied biomarkers for acute brain injury in humans, with an emphasis on traumatic brain injury and stroke.

Part of the book: Trauma, Tumors, Spine, Functional Neurosurgery

By Mark Bender and Linda Papa

There is a growing expectation of physicians to treat acute pain more aggressively in the emergency department (ED). This has contributed to an increase in opiate prescribing practices that has resulted in a crisis of medication abuse and misuse. The resultant backlash against physicians has created a void within the realm of acute pain management, as physicians search for a means to treat their patients in a way that is both empathetic and responsible. In an effort to combat this growing epidemic, alternative means of pain control are being explored. Patient-controlled analgesia devices (PCADs) have been used extensively in multiple fields of medicine and have demonstrated significant clinical utility for treating pain postoperatively; however there is a dearth of evidence to support their use within the acute care setting. Due to this lack of evidence, PCADs have not been widely implemented in the ED. Recent studies have shown that the use of PCADs may improve objective pain scores and increase both patient and nurse satisfaction while reducing the likelihood of developing chronic pain. The economic feasibility of this undertaking remains unclear; however there is strong evidence for the clinical utility of this modality to treat acute pain in this population.

Part of the book: From Conventional to Innovative Approaches for Pain Treatment