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Pain is a discomport that nobody can feel the exact complain that is experienced by the others. Because, someone’s pain is the mildest pain that we have. More than 50% of emergency department visits have pain complaint. Emergency physician’s management of painly conditions and their sence clinic take an important role for making accurate diagnosis.
ISSN 2379-4046 http://dx.doi.org/10.17140/EMOJ-1-e002 Open Journal Editorial Which Pain is Treated at the Emergency * *Corresponding author Department?
Feriyde Çalışkan Tür, MD Attending Physician on Emergency Medicine, and Acupuncture Practitioner * Republic of Turkey Minister of Health Feriyde Çalışkan Tür* Foundation of Public Hospitals Izmir Union of Public Hospitals North General Secretary Attending Physician on Emergency Medicine, and Acupuncture Practitioner, Republic of Tur- Izmir Tepecik Training and Research key Minister of Health Foundation of Public Hospitals, Izmir Union of Public Hospitals North Hospital General Secretary, Izmir Tepecik Training and Research Hospital, Department of Emergency Department of Emergency Medicine and Acupuncture Clinic Medicine and Acupuncture Clinic, Izmir, Turkey Izmir, Turkey Tel. +90-232-4696969/3755 E-mail: feriyde@hotmail.com Pain is a discomport that nobody can feel the exact complain that is experienced by the others. Because, someone’s pain is the mildest pain that we have. More than 50% of Volume 1 : Issue 4 emergency department visits have pain complaint. Emergency physician’s management of Article Ref. #: 1000EMOJ1e002 painly conditions and their sence clinic take an important role for making accurate diagnosis. A 27-year-old healthy woman with complaints of right flank pain was admitted to Article History th emergency department for a while. She stated that previously she has been treated for her pain Received: November 27 , 2015 th diagnosed as renal colic, and it recurred. She also had blurred vision. Nausea was positive Accepted: November 27 , 2015 th obviouse vomiting was did not occur. 6-7 hours pased since the last emergency visit, and visual Published: November 27 , 2015 symptoms began immadiatly she was discharged. She was treated with a narcotic analgesic and metoclopramide. Additionally N-Hyoscine butylbromide was injected intravenously. Her Citation vital signs were completely within normal limits. She did nor state any discomfort except Tür FC. Which pain is treated at right coctovertebral tenderness during physical examination. Her neurological examination the emergency department? Emerg Med Open J. 2015; 1(4): e5-e6. including visual field was normal. There was no other signs in addition to her complaint and doi: 10.17140/EMOJ-1-e002 medical history. Tramadol 100 mg/IV infusion was administered as narcotic analgesia. After an hour her pain was decreased and she was not discomforted of blurring vision. The emergency physician had explain that sometimes blurring complaint may give rise due to side effect of drug hypersensitivity as she was administered. She was asked and advised to coming back if she became discomfortable again. Next day, she came back to the emergency department and suffered from vomiting, blurred vision, headache and described right flank pain again. This time the emergency physician examined the patient more carefully due to the new syptoms and brain computurised tomography imaging was obtained. The brain tomography revealed parenchymal hemorrhage at the right occipital lobe in 2x2 cm area. The patient was transferred to another hospital for neurosurgical intervention.
Now, we want to discussed the emergency setting. Many of the emergency physicians, it is concentrated on to the first and remarkable condition and this was the flank pain for our case. But the physician was not aware of the problem. Other symptomes were weak. Every emergency physician can think that the flank pain due to renal colic is the worst pain for someone can experience. But mainly in my estimation, physicians don’t think that pain can cause to a serious complication. That is the interesting point of pain management.
‘Pain’ even should be considered as a vital sign and assessed accordingly. However, sometimes pain is not interrelated with other (as well as our case, pain and blurred vision) Copyright complaints may not assessed together. The reason of this could be a side effect of the drug, ©2015 Tür FC. This is an open ac- as it was seem in our case. Indeed, metoclopramide with anticholinergic and extrapyramidal cess article distributed under the effects, opiad by producing myozis with specific receptors , and Hiyosin N-butylbromide may Creative Commons Attribution 4.0 be associated with anticholinergic effects may cause vision problems disrupting accomodation. International License (CC BY 4.0), The question ‘’Can an unrelated complaint accompany of pain’ is important. In fact, a severe which permits unrestricted use, distribution, and reproduction in pain may lead to another complication, such as renal colic itself, which is defined as the worst any medium, provided the original labor pain by the experienced. However, severe renal colic can lead to a tear and bleeding in work is properly cited.
patients who have cranial arterial malformations and produce a clue for blurred vision due to its ISSN 2379-4046 http://dx.doi.org/10.17140/EMOJ-1-e002 Open Journal localization of the bleeding, as in our case. But, the unrelated complaint may be assessed as the side effects of lengthened medical treatment.
In such a case, how should an emergency physician behave in a way of treatment focused on hard work and careful examination. Although there is not a powerful guide to give vision to physicians, sense clinic which means what they thinks and feels the signs he/she estimates to exist in his/her patient, open the way of diagnosing and treatment. But either the physician must be a specialist or have forsight or have a senior experienced collague to consult and find out before deciding the optimal treatment and satisfy the patient. Sometimes emergency physician might be in state of asking for some tests unneceserily or showing responsibility by other consulting or referring the patient to other departments.
In other word, pain is an emergency setting that a physician must even be susceptible to the patient. This must not be forgotten.
CONSENT The patient has provided written permission for publication of this manuscript.