Strategies for dealing with patient pain during the procedure germany 2010

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Strategies for dealing with patient pain during colonoscopy Ersta Hospital, Stockholm. Edgar Jaramillo

We should always aim towards our goal: To gain and keep the patient’s confidence and peaceful of mind.

How to react if the patient is under distress? Talk to the patient to calm him/her down. Reassure him/her that nothing dangerous is going to occur. Get help from your nurse assistant to have a continuous dialogue with the patient.

Stop temporally doing other things to concentrate on the patient.

If the patient is still in distress give some sedative. Midazolam 1,0-2,5 mg iv is usually sufficient.

Check if there is a loop and if so, reduce it.

Is the abdomen distended due to increased amount of air? If so, try to suck as much air from the lumen as possible. Even tell the patient to evacuate air and not to feel embarrassed.

Are there adhesions or a severe diverticular disease? Change to a thinner instrument .

If the patient has pain, do not hesitate to give a painkiller. 0,25-0,5 mg iv alfentanyl is usually effective.

The painkiller should be given as soon as you feel that a following maneuver will inevitably cause pain. Do not wait until the patient is suffering. The purpose is to perform a painless procedure.

If you have to give sedatives and painkillers do not think that you failed. Think of the patient and your commitment to assure a painless procedure as much as possible.

Do not hesitate to call for help from an experienced colleague.

If all above mentioned maneuvers do not help…. then stop the procedure.

Keep calm, always having a honest talk with the patient.

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Strategies for dealing with patient pain during the procedure germany 2010

1. Strategies for dealing with patient pain during colonoscopy Ersta Hospital, Stockholm. Edgar Jaramillo

2. We should always aim towards our goal: To gain and keep the patient’s confidence and peaceful of mind.

3. How to react if the patient is under distress? Talk to the patient to calm him/her down. Reassure him/her that nothing dangerous is going to occur. Get help from your nurse assistant to have a continuous dialogue with the patient.

4. Stop temporally doing other things to concentrate on the patient.

5. If the patient is still in distress give some sedative. Midazolam 1,0-2,5 mg iv is usually sufficient.

6. What to do if there is pain?

7. Check if there is a loop and if so, reduce it.

8. Is the abdomen distended due to increased amount of air? If so, try to suck as much air from the lumen as possible. Even tell the patient to evacuate air and not to feel embarrassed.

9. Are there adhesions or a severe diverticular disease? Change to a thinner instrument .

10. If the patient has pain, do not hesitate to give a painkiller. 0,25-0,5 mg iv alfentanyl is usually effective.

11. The painkiller should be given as soon as you feel that a following maneuver will inevitably cause pain. Do not wait until the patient is suffering. The purpose is to perform a painless procedure.

12. If you have to give sedatives and painkillers do not think that you failed. Think of the patient and your commitment to assure a painless procedure as much as possible.

13. Do not hesitate to call for help from an experienced colleague.

14. If all above mentioned maneuvers do not help…. then stop the procedure.

15. Keep calm, always having a honest talk with the patient.

Strategies for dealing with patient pain during the procedure germany 2010

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