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Doreen Koepp

on 26 September 2016

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Transcript of Pain

Pain and how we manage it?
Main Idea
If I can manage pain with as little medical intervention as possible, I can promote quality of life, prevent falls and injury, bring a smile to someone, and promote wellness and dignity.
If medical intervention is needed, I can use as little as possible to promote comfort or titrate to promote comfort.
My main goal is QUALITY OF LIFE.
In this presentation we will discuss:
Types of pain
Measuring pain
Pain management with Medication
Pain management with out medication
Summary of Pain
What makes us happy or feel good?
What causes pain?
The world Health Organization (WHO)
Titrated pain management is based on the total % of breakthrough used in a 24 hr period.

ex: breakthrough availability is Q4h. Person may have 6 breakthrough tabs / day.
Person uses 5 breakthrough tabs in a 24 hr period This is breakthrough of 80%, increase pain management by 25-50% if the person is not sedated.
If pain management is achieved and if the person
is sedated you will decrease pain management by 25-50%

Descriptions of pain

Wong-Baker faces of pain rating scale.
Numerical rating

Non pharmacological pain management.
Management of anxiety and depression.

Pain can be managed for
comfort and quality of

With data collection, trouble shooting and
time we can achieve our goal.

Items to consider:
Does the person have adaquate
renal or hepatic function to metabolize appropriately???
IF not, the person is at risk for toxic levels, sedation, or respiratory arrest.
Is the person narcotic naive? If so, need for narcotic intervention is minimal as effect will be great. If not, need for narcotic intervention is greater as tolerance for narcotic intervention is greater.
Drug Indications
Non-steroidal anti-inflammatory drugs (NSAIDs)
Bone pain
Soft tissue infiltration/inflamation

Raised intracranial pressure
Soft tissue infiltration/inflamation
Nerve compression

Antidepressants and anticonvulsants
Nerve compression or infiltration
Paraneoplastic neuropathies

Bone pain

Ketamine (specialist use only)
Refractory pain
Neuropathic pain
Ischaemic limb pain
Anxiety is pain
Full transcript