Test group
Pain, allergy, pain, NRS, trauma
ALLERGY, DISEASES
The core aim of the new pain relief management mode is to establish a pain management group composed of medical personnel from the emergency department, orthopaedics department and anaesthesiology department. Members of the working group have received unified training on the new pain relief mode.The communication within the group is through instant messaging software. All the accounts of the working group are public. The doctors on duty in each department swill log in to the account to join the working group during working hours and see past data and real-time information on their smartphones, computers and other devices. The data in the working group do not include private data other than the patient's medical information and will be completely cleared before the patient is discharged.1. Admission evaluation: The emergency medical staff will conduct the first comprehensive evaluation after the patient is admitted to the hospital and will send the evaluation results (general information of the patient, trauma, numerical rating scale [NRS] score, coexisting diseases, history of past illness and allergy history) to the working group.2. Analgesic scheme: All patients will be given a multimodal analgesic scheme before the operation. The basic analgesia is flurbiprofen axetil administered for 12 h. The affected side will be treated with 0.25% ropivacaine for fascia iliaca compartment block (FICB). The interval between two blocking operations should not be less than 8 h. After the completion of FICB, when the patient's pain NRS score is still > 3, he or she will take one tablet of oxycodone and acetaminophen orally.3. FICB: FICB will be implemented as soon as conditions permit. FICB can be completed by any doctor familiar with the operation, such as an emergency department physician or anaesthesiologist. During the operation, the ultrasound images of patients will also be shared in the working group in real time, and other doctors familiar with the FICB operation will also conduct remote guidance and consultation.4. Pain self-assessment: Educate patients on how to correctly use the NRS to assess their pain level. The NRS describes the pain intensity on a scale of 11 points that increase from 0 to 10. The specific scores are as follows: 0 indicates no pain, 1–3 indicates mild pain, 4–6 indicates moderate pain, 7–9 indicates severe pain, and 10 indicates the most severe pain. Patients with an NRS score of > 3 points can inform doctors to seek additional analgesic treatment.5. Pain closed-loop management: The dosage and effect of FICB for each patient are used as a reference for continuous treatment, and the information is stored as a case in the shared document of the working group. The changes in patients' pain scores and the additional use of oral analgesics will be recorded and summarized, the changes in the patients' pain will be tracked, and these data will be published to the working group. For patients with high pain scores, intragroup consultation will be conducted to consider increasing the concentration or dose of drugs in the next FICB.