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Pain Management
- 17. Wong-Baker FACES Pain Scale From Hockenberry MJ, Wilson D, Winkelstein ML: Wong's Essentials of Pediatric Nursing , ed. 7, St. Louis, 2005, p. 1259. Used with permission. Copyright, Mosby.
Editor's Notes
- 1.Something is wrong Tissue is being damaged Limit a personโs function Factors that affect how a person experiences pain. 1. Cultural 2. Social 3. Age 4. Cognitive ability 5. Emotional state
- Side effects of pain. Pain is a very real feeling and chronic pain can be devastating. These are just a few examples. More examples can be found by searching the web.
- Nociceptors and sensory neurons 1. Located at nerve endings in the skin, muscle, bone, blood vessels and internal organs Message is transmitted by nerves from the site to the spinal cord Spinal cord to the Brain and Muscles at the site Brain, Releases endorphins, Chemicals Temporary pain relief, Inflammatory response, Protect and repair damage Muscles at the site contracts to prevent further damage
- Acute=Slow or sudden onset, Mild to severe, Immediate, identifiable cause, Temporary, Protective, Subsides with healing Chronic=Continued more than 6 months, Slow onset, Long lasting, Ono-productive (serves no purpose), Adverse affects, Can limit a personโs physical and mental capabilities, Can incapacitate., Reduces quality of life Differentiate acute from chronic, Time Cause Provide participants with examples of both acute and chronic and ask them to differentiate the two and provide the reason for their decision.
- Somatic, Nociceptors, Coetaneous / surface , Deep tissue / musculoskeletal , Localized to damaged area Surface somatic pain, Sharp, Stabbing, Prickly / burning Deep somatic pain, Dull, Aching. Responds to Cold packs, Nonsteroidal anti-inflammatory drugs โ NSAIDS, Opiates Local anesthetics. Visceral, Internal body organs and cavities, Infiltration, Compression, Extension, Stretching. Pain is Diffuse, Difficult to locate, Pressure-like , Deep squeezing sensation , Cramping. Responds well to opiates Neuropathic Changes or injuries to nervous system. Pain is Severe, Burning or tingling sensation. Causes, Infection Inflammation, Tumors, Scar tissue, Diabetes, Medical conditions. Responds well to opiates. Breakthrough Pain, Brief flare up Severe, Chronic pain sufferers , Quick onset, Temporary, Common for cancer / Hospice Pts.. Responds well to strong short acting pain medications
- O-Onset of pain Acute vs. Chronic P-Provokes/palliation. Better or Worse Q-Quality, Sharp/stabbing, Dull, Weight, Pressure, Burning, Numbness/tingling R-Radiation, Disease process, MOI S-Severity Pain scales T-Time, When did it start? Constant Better/worse On-going assessment Consider the need for a detailed assessment. Re-assessment, Repeats vital signs, Re-assess to determine if treatment is working
- O-Onset of pain Acute vs. Chronic P-Provokes/palliation. Better or Worse Q-Quality, Sharp/stabbing, Dull, Weight, Pressure, Burning, Numbness/tingling R-Radiation, Disease process, MOI S-Severity Pain scales T-Time, When did it start? Constant Better/worse On-going assessment Consider the need for a detailed assessment. Re-assessment, Repeats vital signs, Re-assess to determine if treatment is working
- Addiutional information about pain scales can be found by using the Web.
- To review each pain scale prior to teaching the following web-sties are useful http://www.anes.ucla.edu/pain/assessment_tools.html http://painconsortium.nih.gov/pain_scales/index.html
- To review each pain scale prior to teaching the following web-sties are useful http://www.anes.ucla.edu/pain/assessment_tools.html http://painconsortium.nih.gov/pain_scales/index.html
- To review each pain scale prior to teaching the following web-sties are useful http://www.anes.ucla.edu/pain/assessment_tools.html http://painconsortium.nih.gov/pain_scales/index.html
- To review each pain scale prior to teaching the following web-sties are useful http://www.anes.ucla.edu/pain/assessment_tools.html http://painconsortium.nih.gov/pain_scales/index.html
- To review each pain scale prior to teaching the following web-sties are useful http://www.anes.ucla.edu/pain/assessment_tools.html http://painconsortium.nih.gov/pain_scales/index.html
- To review each pain scale prior to teaching the following web-sties are useful http://www.anes.ucla.edu/pain/assessment_tools.html http://painconsortium.nih.gov/pain_scales/index.html
- Communication is the primary way we can assess a personโs pain. We will be faced with many barriers to communication and must improve our assessments and use our assessment tools to overcome communication challenges.
- Communication, Key element, Compassion. How you can help Distraction Change the patients focus Repositioning=Comfort Pad voids, Pillows, Warm, Cool
- Peripheral acting, Pain detected at the tissues, Non-steroidal anti-inflammatory drugs-NSAIDS, Block the pain impulse that causes the release of inflammatory responses. Centrally acting, Relieve both physical and emotional pain, Common CNS agents are opiates Fentanyl=Preferred analgesic, Few adverse affects, Reduced nausea, sedation and respiratory depression than other CNS agents, Fast acting, Short duration, Most all patients, Dosage 25-100 micrograms, Reversed easily with narcan. Nitronox=50% oxygen, 50% nitrous, Inhaled gas, Rapidly absorbed and delivered to the brain, Few side affects Light-headedness, Nausea, Altered mental status. BLS level of care. Contraindication, Trapped gas, Pneumothorax Small bowel obstruction
- Peripheral acting, Pain detected at the tissues, Non-steroidal anti-inflammatory drugs-NSAIDS, Block the pain impulse that causes the release of inflammatory responses. Centrally acting, Relieve both physical and emotional pain, Common CNS agents are opiates Fentanyl=Preferred analgesic, Few adverse affects, Reduced nausea, sedation and respiratory depression than other CNS agents, Fast acting, Short duration, Most all patients, Dosage 25-100 micrograms, Reversed easily with narcan. Nitronox=50% oxygen, 50% nitrous, Inhaled gas, Rapidly absorbed and delivered to the brain, Few side affects Light-headedness, Nausea, Altered mental status. BLS level of care. Contraindication, Trapped gas, Pneumothorax Small bowel obstruction
- Peripheral acting, Pain detected at the tissues, Non-steroidal anti-inflammatory drugs-NSAIDS, Block the pain impulse that causes the release of inflammatory responses. Centrally acting, Relieve both physical and emotional pain, Common CNS agents are opiates Fentanyl=Preferred analgesic, Few adverse affects, Reduced nausea, sedation and respiratory depression than other CNS agents, Fast acting, Short duration, Most all patients, Dosage 25-100 micrograms, Reversed easily with narcan. Nitronox=50% oxygen, 50% nitrous, Inhaled gas, Rapidly absorbed and delivered to the brain, Few side affects Light-headedness, Nausea, Altered mental status. BLS level of care. Contraindication, Trapped gas, Pneumothorax Small bowel obstruction
- Peripheral acting, Pain detected at the tissues, Non-steroidal anti-inflammatory drugs-NSAIDS, Block the pain impulse that causes the release of inflammatory responses. Centrally acting, Relieve both physical and emotional pain, Common CNS agents are opiates Fentanyl=Preferred analgesic, Few adverse affects, Reduced nausea, sedation and respiratory depression than other CNS agents, Fast acting, Short duration, Most all patients, Dosage 25-100 micrograms, Reversed easily with narcan. Nitronox=50% oxygen, 50% nitrous, Inhaled gas, Rapidly absorbed and delivered to the brain, Few side affects Light-headedness, Nausea, Altered mental status. BLS level of care. Contraindication, Trapped gas, Pneumothorax Small bowel obstruction
- Pain relief is part of patient care !!!!!! Make sure you do it!!!!!
- Pain relief is part of patient care !!!!!! Make sure you do it!!!!!