Pain Management by QCT277


									Pain Management
                  Pain is
• “an unpleasant sensory and
 emotional experience
 associated with actual or
 potential tissue damage or
 described in terms of such
 damage.” (International
 Association for the Study of
                Is subjective
      Interferes with the quality of life
  Must be assessed on a continuing basis
   May compromise the immune system
May hasten death by increasing psychological
 Pain is measured by
• Pattern
• Location
• Quality
• Intensity
       Pain can be measured by
• Pattern: Acute pain comes on
  suddenly; chronic pain is always
• Quality: aching, squeezing,
  throbbing, burning, tingling, shooting
• Location: Where does it hurt?
• Intensity: on scale of 10, with 0 no
• History: When did it start? How long
  did it last? What brought it on?
• Aggravating/alleviating factors:
  What makes it worse or better?
• Medication history: When did you
  last take something for the pain?
  Did it help?
• Meaning of pain: reactions to pain
  vary with cultural backgrounds
• Physical exam: adds to information
  about other components of pain
• Reassessment: necessary so
  needed changes can be made
   Assessment of pain includes
• Physical exam
   •To see patient as a whole
• Psychological and cultural
   •To help explain response to
• Diagnostic work up
   •To find cause of pain
      Tools for pain evaluation
• Nurses discovered they could
  get responses from children by
  using faces.
   •Original faces ranged from 1-
   •Modified to range 1-10
• Adults respond better to
  horizontal numerical scale
Wong-Baker FACES scale
    Horizontal numerical scale

0   1   2   3   4   5   6   7   8   9   10
Interference with pain control

 • Caregivers
 • Healthcare systems
 • Patients
       Interference by caregivers

• Improper assessment of pain
• Concern that the patient might
  become addicted
• Concern about unpleasant side
  effects from narcotics
• Giving too little medication
 Interference by healthcare systems
• Lack of understanding about
  pain management
• Not enough places to go for
• Concerns about addiction to
  controlled substances
• Inadequate reimbursement
       Interference by patients
• Concern about perception of
  being a “good patient.”
• Afraid to report pain
• Reluctant to take medicines at
• Fear of addiction or of becoming
  tolerant to pain medicine
• Side effects of narcotics
• Cost

To top