Harold is an adult male with pain from trauma experienced in a car accident. This case covers assessing the aspects of the pain experience in a trauma patient with substance use disorder by integrating the health history into the treatment decision-making process, examining multimodal approaches to treat acute trauma across transitions of care, recognizing the biopsychosocial impact of the treatment of acute pain in patients with substance use disorder, and designing an appropriate treatment plan using case-based learning to address acute trauma related pain in patient with substance use disorder.
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Mr. Frank is an 80-year-old nursing home resident. Recent years have been marked by progressive cognitive decline attributed to Alzheimer’s disease. Two days prior to admission, the nursing home staff noted decreased oral intake and resistance to care but were able to dose usual medications. This progressed over the subsequent day with Mr. Frank noted to be agitated, resistant to care and uncharacteristically aggressive. Transfer to acute care facility was arranged after Mr. Frank fell from his chair.
This case presentation follows a 43-year-old farmer named Mr. Lane who injured his right arm after it got stuck in a combine. He was then air lifted to a tertiary care center. The case includes Mr. Lane's initial injury, acute pain, and the development of chronic pain and acute on chronic pain.
Ms. Mondragon is a thin, 71-year-old, widowed Hispanic Spanish-Speaking woman whose son is serving as interpreter in the emergency department. Ms. M. fell this morning in her kitchen. She presents with upper back pain, groin pain, and left hip pain radiating anteriorly to the knee.
Ms. Tatum is a 30 year-old woman with a history of opioid use disorder (heroin and fentanyl) who has been treated for 2 months with buprenorphine/naloxone (Suboxone) in a substance use disorder treatment program. 4 months after she transitioned her medications to her PCP, she was in a Motor Vehicle Accident and sustained multiple left-sided rib fractures as well as a jaw fracture. She has severe pain in the face, neck, and ribs and needs an acute pain management plan.
Sarah suffers whiplash following a car accident. She then goes on to develop widespread pain and associated fatigue. Her pain interferes with work and daily activities.
Keywords: Acute, Chronic, Depression, Generalized, Head/Neck, Rheumatic/Fibromyalgia, Sleep and Fatigue, Trauma, Young Adult