Pain Management PDF

Pain Management Prepared by Suzanne Badawi Pain Management Pain : is a localized or generalized unpleasant bodily sensation or complex of sensations that causes mild to severe physical discomfort and emotional distress and typically results from bodily disorder (as injury or disease). Mos...

Pain Management Prepared by Suzanne Badawi Pain Management Pain : is a localized or generalized unpleasant bodily sensation or complex of sensations that causes mild to severe physical discomfort and emotional distress and typically results from bodily disorder (as injury or disease). Most pain comes from tissue damage, the injury can be to bone, soft tissue, or organs. Or it can come from a physical injury, like a cut or a broken bone. Pain Classification: _ Acute pain: usually comes on suddenly and lasts for a limited time. Some type of damage to tissue – such as bone, muscle, or organs – often causes it. When it happens, it can cause anxiety or other emotional issues. _ Chronic pain: lasts longer than acute pain. It generally can somewhat resist medical treatment. It's usually linked to a long-term illness, such as osteoarthritis. Chronic pain can be the result of damaged tissue. But very often, nerve damage is behind it. Pain Management Types of Pain: Pain is most often grouped by the kind of damage that causes it Nociceptive Pain Neuropathic Pain Psychogenic Pain Caused by tissue Caused by nerve Affected by damage damage psychological factors Psychogenic pain most often has a physical origin either in tissue damage or nerve damage Pain Management Pain is subjective and difficult to quantify, because it has both an affective and a sensory component. Use specific features to describe a patient's pain:(ASK PQRST) 1. Region of the body involved: Where your pain is?(e.g. abdomen, lower limbs), 2. System whose dysfunction may be causing the pain (e.g., nervous, gastrointestinal)/ How much it’s affecting your life and work. 3. Duration and pattern of occurrence :How often it occurs? 4. Intensity: How intense it is, on a scale of 0 to 10/ What makes it worse or better 5. Cause: Whether you’ve had any illnesses or surgeries/ Whether you have a lot of stress or anxiety in your life Pain Management Breakthrough pain: is transitory pain that comes on suddenly and is not alleviated by the patient's regular pain management. It is common in cancer patients who often have background pain that is generally well-controlled by medications, but who also sometimes experience bouts of severe pain that from time to time "breaks through" the medication. The characteristics of breakthrough cancer pain vary from person to person and according to the cause. Management of breakthrough pain can entail intensive use of opioids. Pain Management Chronic pain: is pain that lasts for over three months. The pain can be there all the time, or it may come and go. It can happen anywhere in your body. Chronic pain: can interfere with daily activities, such as working, having a social life and taking care of himself or others. It can lead to depression, anxiety and trouble sleeping, which can make the pain worse. Chronic pain can come in many different forms and appear across your body. Common types of chronic pain include: arthritis, neck pain, back pain, headache, muscles pain, neurogenic and cancer pain. Symptoms: Aching, burning, shooting, squeezing, stiffness, stinging, throbbing. Leads to: Anxiety, depression, fatigue, insomnia. Pain Management Treatment for Chronic Pain: Anticonvulsants (medications that prevent seizures) for nerve pain. Antidepressants such as tricyclic antidepressants. Corticosteroid Muscle relaxers. Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen. Topical products (applied to the skin) that contain pain relievers or ingredients that create soothing heat or cold. Opioids (narcotics). Opioids can be addictive, and you can build up a tolerance to them over time. Because of this, healthcare providers usually try other pain treatment options before prescribing opioids. Sedatives to help with anxiety or insomnia. Pain Management Pain Assessment scales: _ Numerical rating scales (NRS): Uses numbers to rate pain. _ Visual analog scales (VAS): Asks the patient to select a picture that best matches pain level. _ Categorical scales: Primarily uses words, possibly along with numbers, colors, or location(s) on the body. Pain Management The Numerical Rating Scale (NRS): Is designed for anyone over age 9. It is one of the most commonly used pain scales in health care. To use it, patient should say the number that best matches the level of pain he are feeling; Patient can also place a mark on the scale itself.Zero means that the patient have no pain, while 10 represents the most intense pain possible. Pain Management PEDIATRIC The Wong-Baker FACES Pain Scale: Combines pictures and numbers for pain ratings. It can be used in adults and children over age 3. Six faces depict different expressions, ranging from happy to extremely upset. Each is assigned a numerical rating between 0 (smiling) and 10(crying). To use it, patient can point to the picture that best represents the degree and intensity of his pain. PEDIATRIC Adult Pain Management The Mankoski Pain Scale: uses numbers and specific descriptions of pain to ensure that healthcare provider understands the patient pain. Descriptions are detailed. They include phrases such as: _ Very minor annoyance _ Occasional minor twinges _ Cannot be ignored for more than 30 minutes _ After reading the descriptions, patient tells the provider which number best fits his pain level. Pain Management Pain Management Nursing Assessment and management of pain: _ Evaluate pain of patients _ Provide measures to relieve pain before it becomes severe _ Acknowledge and accept the client pain, client’s report of pain should be accepted at face value in the absence of evidence _ Assess and note for signs and symptoms related to chronic pain such as weakness, decreased appetite, weight loss, changes in body posture, sleep pattern disturbance, anxiety, irritability, agitation, or depression. _ Evaluate the client’s approach toward pharmacological and nonpharmacological means of pain management. _ Review the client’s current medication use _ Provide nonpharmacologic pain management (massage, heat /cold application, immobilization…) _ Provide pharmacologic pain management as ordered _ Evaluate the effectiveness of the analgesics at regular, frequent intervals Thank you