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PCA pumps and Pain Management
2
Patient-Controlled Analgesia Pumps
PCA PUMPS
What is...?
PATIENT CONTROLLED ANALGESIA
Definition
PCA pumps are patient controlled analgesia that is administered and delivered at the patients discretion. These can be used both in both in-patient and outpatient settings.
We will be discussing
Topics
Indications
Routes of administration
Contraindications
Nursing managment
Policies and Procedures
PCA pumps are designed for patients to self administer a predetermined dose of medication independently
Mechanisms
Used to treat acute, chronic, post operative & labor pain
Indications
Criteria:
- An elective procedure
- Large surgical wounds
- Large traumatic wounds
- Normal cognitive function
- Normal motor skills
- Peripheral IV
- Epidural cathether
- Indwelling nerve catheter
- Iontophoretic transdermal system
Routes
ITS mechanism
Contraindications
- Patients with cognitive impairment
- Sleep apnea or other respiratory issues
- Allergies to selected medications
- Liver or kidney disease
- Inability to communicate
- Physical immobility
Contraindications
Nursing Managment of patients with PCA pumps
Nursing Management
Nurse and Patient education
Education
Nurses are responsible for ensuring the device is safe and working properly.
Verifying the order/dose
Reviewing administration times and doses to evaluating efficacy
Educating patients on how the pump will function (initial dose, bolus or demand, lockout interval, continuous rate, and one & four hour limits
Potential complications include
Complications
Run away pumps
- mechanical errors that give doses at incorrect intervals
PCA by proxy
- When someone other than the patient is pressing the button for administration
- Can lead to respiratory depression, important for nurses to educate family/visitors
Machine tampering
- To prevent tampering with machines and administrations are only permitted by health care provider who has the key/code