Project Abstract Summary
Your total abstract must not be longer than 35 lines. It should include the project name, population(s) to be served (demographics and clinical characteristics), strategies/interventions, project goals and measurable objectives, including the number of people to be served annually and throughout the lifetime of the project, etc. In the first five lines or less of your abstract, write a summary of your project that can be used, if your project is funded, in publications, reports to Congress, or press releases.
The ED-ALT Project that is to be conducted in the Department of Emergency Medicine, Maimonides Medical Center will improve the current analgesic practices for geriatric, pediatric and chronic pain patients by implementing a continuous ketamine infusion protocols in the ED, by establishing a nerve block team in the ED with primary focus on geriatric and pediatric traumatic injuries, by implementing the protocol on administration of buprenorphine for acute and acute on chronic painful conditions, and by reducing the administration of highly addictive opioids ( oxycodone, hydrocodone, tramadol, and hydromorphone) in the ED.
The population of specific interest that will be served by this initiative will comprise of elderly (65 years of age and older) patients with traumatic painful extremities and rib cage injuries, of pediatric patients with acute musculoskeletal injuries, patients with chronic neuropathic pain, and patients with opioid use disorder suffering from acute and acute on chronic painful conditions. The project is aimed to contribute to pain relief of over 2000 geriatric patients with acute musculoskeletal injuries, over 3000 of pediatric patients with acute musculoskeletal injuries, over 1000 with chronic neuropathic pain and over 100 patients with an OUD and acute pain. We project this number of patients to be served annually with a 10% increase per year after throughput the lifetime of the project.
The goals of the project will include the increase in number of ED-performed nerve blocks for geriatric patients presenting to the ED with acute musculoskeletal traumatic pain; the increase in utilization of continuous ketamine infusions for ED patients with chronic pain, neuropathic pain, opioid-tolerant pain and acute geriatric traumatic pain; the reduction in number of orders of highly addictive opioids (oxycodone, hydrocodone) in the ED and in number of opioid prescriptions at discharge; the increase in utilization of virtual reality at triage and in the ED for pediatric patients presenting to the ED with acute traumatic painful conditions. The objectives of this project will include the establishment of an ED Nerve Block Team 4 months from the inception of the project; the creation of an ED protocol with an expansion to CDU for continuous ketamine infusion for patients with chronic pain, neuropathic pain, and opioid-tolerant pain within three months since the initiation of the project; the establishment of an educational module for residents and attending through the simulation encounters on ED opioid utilization with emphasis on reducing administration of highly euphoric and consequently, highly addictive opioids within 3 months from the start of the project; and the implementation of the buprenorphine for pain protocol with an increase in percentage of patients receiving this medication by 10% in the first-year post-implementation,20% by the end of the second year, and by 50% by the end of the third year.