A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfillment of the requirements for the degree of Master Science in Medicine in Emergency Medicine, Johannesburg, 2013 / Objectives:
To describe the current analgesic practices for hand injuries used at a private
hospital emergency department in Johannesburg, Gauteng and to explore any
differences in analgesic practice between different doctor groups with different
backgrounds, working in the ED.
Design:
Retrospective descriptive review.
Setting:
Private hospital emergency department in Johannesburg.
Patients:
A study sample of 423 patients who presented to the emergency department with
hand injuries during 2010.
Methods:
The emergency department register was used to identify patients who presented
with hand injuries. The clinical notes and where appropriate, nursing notes of the
identified patients were reviewed.
Main Results:
Hand injuries were found to represent 9.3% of patients presenting to the
emergency department. The most commonly used form of analgesia for hand
injuries was found to be nerve blocks, which constituted 30% of the analgesic use.
Digital blocks were the most frequently used block accounting for 69% of all nerve
blocks done. Parenteral analgesia was the second most common form of
analgesia implemented with the intramuscular route being most favoured.
Specialised techniques such as nerve blocks are possibly underutilised by doctors
with less surgical and emergency department experience.
Conclusions:
Analgesic practices between different doctor groups are varied. Standardising
pain management for hand injuries should lead to improved utilisation of
techniques such as nerve blocks. Guidelines should be available and include
nerve block techniques. Training should be provided to doctors who are unfamiliar
with the use of additional modalities such as nerve blocks.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/14609 |
| Date | 25 April 2014 |
| Creators | Maloney, Jan Rust |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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