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Background: This consensus statement was developed because there are concerns about the appropriate use of opioids for acute pain management, with opposing views in the literature. Consensus statement on policies for system-level interventions may help inform organisations such as management structures, government agencies and funding bodies.
Methods: We conducted a multi-stakeholder survey using a modified Delphi methodology focusing on policies, at the system level, rather than at the prescriber or patient level. We aimed to provide consensus statements for current developments and priorities for future developments.
Results: Twenty-five experts from a variety of fields with experience in acute pain management were invited to join a review panel, of whom 23 completed a modified Delphi survey of policies designed to improve the safety and quality of opioids prescribing for acute pain in the secondary care setting. Strong agreement, defined as consistent among> 75% of panellists, was observed for ten statements.
Conclusions: Using a modified Delphi study, we found agreement among a multidisciplinary panel, including patient representation, on prioritisation of policies for system-level interventions, to improve governance, pain management, patient/consumers care, safety and engagement.
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http://dx.doi.org/10.1186/s12913-022-07696-x | DOI Listing |
JAMA Netw Open
September 2025
Division of Cardiology, Duke University Hospital, Durham, North Carolina.
Importance: Previous data suggest that the time changes associated with daylight savings time (DST) may be associated with an increased incidence of acute myocardial infarction (AMI).
Objective: To determine whether the incidence of patients presenting with AMI is greater during the weeks during or after DST and compare the in-hospital clinical events between the week before DST and after DST.
Design, Setting, And Participants: This cross-sectional study examined patients enrolled in the Chest Pain MI Registry from 2013 to 2022.
Eur J Trauma Emerg Surg
September 2025
Emergency Medical Services of Karlovy Vary Region, Zavodni 390/98C, Karlovy Vary, 36006, Czech Republic.
Background And Importance: In the Czech Republic, paramedics are required to consult a physician before administering intravenous opioids, which may delay effective prehospital pain management. As paramedic competencies expand in Europe, it is important to evaluate the safety and efficacy of independent opioid administration in prehospital emergency care settings.
Objectives: To assess the safety and effectiveness of intravenous sufentanil administered independently by trained paramedics compared to administration following remote physician consultation in adult trauma patients.
Ann Afr Med
September 2025
Department of Pediatrics, MGM Medical College and LSK Hospital, Kishanganj, Bihar, India.
Autoimmune hemolytic anemia (AIHA) is uncommon in the pediatric population, particularly when it manifests as severe anemia. AIHA is characterized by a positive direct antiglobulin test (DAT) and immune-mediated red blood cell (RBC) destruction. AIHA is subclassified on the basis of the thermal characteristics of autoantibody into warm, cold, and mixed.
View Article and Find Full Text PDFAnn Afr Med
September 2025
Department of Gynaecology, Tata Main Hospital, Dhanbad, Jharkhand, India.
A case of 25-year-old primigravida with 8 weeks of pregnancy presented to gynaecology outpatient department with severe abdominal pain. The patient has been receiving treatment outside and conceived after ovulation induction and timed intercourse. She was diagnosed with twisted ovarian cyst, twin pregnancy, and sepsis.
View Article and Find Full Text PDFJMIR Serious Games
September 2025
Women's and Newborn Program, Monash Health, 246 Clayton Rd, Melbourne, 3168, Australia, 61 395946666.
Background: Intrauterine devices (IUDs) are safe and effective long-acting reversible contraceptive therapies that are also used as minimally invasive treatment for heavy menstrual bleeding, endometrial hyperplasia, and early-stage endometrial cancer. Despite many advantages, IUDs are underused predominantly due to patient discomfort. Although many techniques have been explored previously in the literature, there is currently little consensus on effective analgesic strategies.
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