Pain Clinical Trial
Official title:
Intensive Cryotherapy in the Emergency Department (ICED) Versus Conventional Treatment for Acute Musculoskeletal Injuries: The ICED Randomized Controlled Trial
Acute musculoskeletal (MSK) injuries, including strains, sprains or contusions, are a common
reason patients seek emergency care. Pain control is an essential component of treatment.
Within the orthopedic literature, there is robust body of research supporting the use of
cryotherapy for post-operative patients and injured athletes. However, within the emergency
department (ED), studies have been focused on pharmacologic analgesia. The absence of
evidence on optimal method or impact of ice therapy for acute MSK injuries contributes to
inconsistent practice patterns that may impede symptom control or increase narcotic usage.
The specific aim of the ICED investigation is to evaluate the effectiveness of intensive
cryotherapy for the treatment of pain due to acute MSK injuries treated in the ED. Secondary
outcomes include length-of-stay (LOS), patient satisfaction, and narcotic usage.
Background Acute musculoskeletal (MSK) injuries, including strains, sprains or contusions,
are a common reason patients seek emergency care. Pain control is an essential component of
treatment. Within the orthopedic literature, there is robust body of research supporting the
use of cryotherapy for post-operative patients and injured athletes. However, within the
emergency department (ED), studies have been focused on pharmacologic analgesia. The absence
of evidence on optimal method or impact of ice therapy for acute MSK injuries contributes to
inconsistent practice patterns that may impede symptom control or increase narcotic usage.
Objectives The specific aim of the ICED investigation is to evaluate the effectiveness of
intensive cryotherapy for the treatment of pain due to acute MSK injuries treated in the ED.
Secondary outcomes include length-of-stay (LOS), and narcotic usage.
Methods Adults younger than sixty-six years-old presenting to the ED with acute MSK pain are
enrolled through a process of informed consent, unless one or more of the exclusion criteria
are met. Crushed ice is double-bagged and applied at the site of injury, where it is wrapped
in place for twenty minutes. Pain scores are measured using a visual analog scale (VAS) when
the ice is applied, at 20 minutes and at 60 minutes. Treating physicians do not alter their
management. Data on LOS and use of pharmacologic analgesics are obtained through chart
review.
Results Change in VAS will be analyzed with regression analysis and analysis of variance.
Patients are grouped into categories of pharmacologic analgesic usage. Patient satisfaction
scores and narcotic usage will be analyzed using a Chi Square test, while LOS data compared
with an unpaired two-tailed t-test.
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