Consultation for total pain in high-risk obstetrics.

MedStar author(s):
Citation: BMJ supportive & palliative care. 8(1):64-66, 2018 Mar.PMID: 28838932Institution: MedStar Washington Hospital CenterDepartment: Medicine/Palliative CareForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Abdominal Pain/pc [Prevention & Control] | *Pain, Intractable/pc [Prevention & Control] | *Palliative Care | *Pregnancy Complications | *Referral and Consultation | Abdominal Pain/et [Etiology] | Adult | Female | Humans | Obstetrics/mt [Methods] | Pain, Intractable/et [Etiology] | Pregnancy | Risk Factors | Treatment Outcome | Young AdultYear: 2018Local holdings: Available online through MWHC library: 2011 to the presentISSN:
  • 2045-435X
Name of journal: BMJ supportive & palliative careAbstract: Palliative care (PC) consultation rarely takes place in the clinical setting of high-risk obstetrics, where 'total pain' may be undermanaged. Here, we present a case of a young woman carrying twins and hospitalised for acute abdominal pain. Workup for her pain revealed non-viable fetal tissue positioned in the uterine horn; the remaining fetus was viable. Initial attempts to control the patient's pain with strong parenteral opioids by the obstetrics team and the acute pain service failed. The PC service was consulted to assist. Applying a customary interdisciplinary approach in a novel PC clinical setting, the PC service was able to identify and attend to the patient's physical, psychosocial and spiritual pain, resulting in an overall decrease in reported pain scores, decreased opioid requirement and a plan for preservation of the viable fetus. Copyright (c) Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.All authors: Groninger H, Mackie-Jenkins W, Tosca RMOriginally published: BMJ supportive & palliative care. , 2017 Aug 24Fiscal year: FY2018Digital Object Identifier: ORCID: Date added to catalog: 2017-09-18
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 28838932 Available 28838932

Available online through MWHC library: 2011 to the present

Palliative care (PC) consultation rarely takes place in the clinical setting of high-risk obstetrics, where 'total pain' may be undermanaged. Here, we present a case of a young woman carrying twins and hospitalised for acute abdominal pain. Workup for her pain revealed non-viable fetal tissue positioned in the uterine horn; the remaining fetus was viable. Initial attempts to control the patient's pain with strong parenteral opioids by the obstetrics team and the acute pain service failed. The PC service was consulted to assist. Applying a customary interdisciplinary approach in a novel PC clinical setting, the PC service was able to identify and attend to the patient's physical, psychosocial and spiritual pain, resulting in an overall decrease in reported pain scores, decreased opioid requirement and a plan for preservation of the viable fetus. Copyright (c) Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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