Mcgill Pain Questionnaire Visual Analogue Scale
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How to Complete a Rapid Pain Assessment in a Busy ED
How to Complete a Rapid Pain Assessment in a Busy ED Phyllis Hendry, MD Sophia Sheikh, MD Course Description .Pain is a component of up to 78% of ED presenting complaints yet most ED physicians have had minimal training related to pain recognition, assessment and management. Adequate pain assessment is complex and requires time to determine the patient’s past pain and medication history, current pain history, and pain intensity. ED providers are under pressure to recognize and treat pain while also dealing with overcrowding, a vast array of patient complaints, and concerns over opioid addiction and over prescribing. This course will review critical components of a rapid ED pain assessment, the current status of pain scales in the ED, electronic medical record documentation of pain and current literature. Disclosures .Phyllis Hendry, MD, FACEP, FAAP (Principal Investigator) .Sophia Sheikh, MD, FACEP (Sub-Investigator) .Pain Assessment and Management Initiative (PAMI) .Funded by Florida Medical Malpractice Joint Underwriting Association, Alvin E. Smith Safety of Health Care Services Grant: 2014-2018 Learning Objectives .Describe various pain assessment tools currently in the literature and pros/cons to using these tools in the ED setting; .Discuss barriers to utilizing pain assessment tools and ways to overcome those barriers; .List advantages to implementing a common pain assessment tool in the ED among the entire ED health care team; and .Discuss evidence and controversy behind pain and patient satisfaction scores. Pain as of August 2016 .Total upheaval in the world of pain management –New research regarding the neurobiological complexity of pain and long term consequences of untreated acute pain. -
Pain Management Assessment and Reassessment
North Shore-LIJ Health System is now Northwell Health System Patient Care Services POLICY TITLE: CLINICAL POLICY AND PROCEDURE Pain Management: Assessment and MANUAL Reassessment POLICY #: PCS.1603 CATEGORY SECTION: System Approval Date: 10/20/16 Effective Date: NEW Site Implementation Date: 12/2/16 Last Reviewed/Revised: NEW Prepared by: Notations: System Nursing Policy and Procedure This policy was created by incorporating the Committee Northwell Health’s Geriatric Guidelines for Pain Management into the Northwell Health’s Pain Management : Assessment and Reassessment Policy dated 11/10 that can be found on the Intranet. GENERAL STATEMENT of PURPOSE To establish a standard for routine assessment, reassessment and documentation of pain as appropriate to the patient’s condition and treatment regimen. POLICY 1. Patients are screened and assessed for pain based upon clinical presentation, services sought, and in accordance with the care, treatment, and services provided. Facility personnel use methods to assess pain that are consistent with the patient’s age, condition, and ability to understand. 2. If the patient reports pain to a health care worker other than a licensed health care provider, the health care worker will escalate the report of pain to a licensed health care provider for assessment. 3. Pain assessment performed by health care providers will address individual, cultural, spiritual, and language differences. Pain measurement scales are available in various languages and, if necessary, access to a medical interpreter will be provided to assist in the evaluation of the patient’s pain. 4. The patient’s self-report of pain is considered the “gold standard.” For those patients who are unable to communicate the health care provider will assess pain by using the appropriate pain Measurement Scale. -
Gabapentin for the Management of Chronic Pelvic Pain in Women
Archives of Gynecology and Obstetrics (2019) 300:1271–1277 https://doi.org/10.1007/s00404-019-05272-z GENERAL GYNECOLOGY Gabapentin for the management of chronic pelvic pain in women M. A. AbdelHafeez1 · A. Reda1 · A. Elnaggar1 · H. EL‑Zeneiny1 · J. M. Mokhles1 Received: 4 March 2019 / Accepted: 8 August 2019 / Published online: 21 August 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019 Abstract Background Chronic pelvic pain (CPP) is a frequent presenting symptom in gynaecology outpatient clinics. Neuromodulator pharmacological agents could be an option for treatment based on its efcacy in treating chronic pain in other conditions. Purpose This study aimed at evaluating the efcacy of oral Gabapentin to alleviate pain in women with CPP. Methods In a randomized double-blinded placebo-controlled trial, 60 women sufering from chronic pelvic pain were ran- domly divided into two equal arms. The study group received Gabapentin 300 mg three times daily initially (900 mg), with 300 mg weekly incremental dose till pain was controlled, severe side efects occurred or maximum daily dose of 2700 mg was reached. The Primary outcome was the pain score improvement of CPP, defned as a 30% reduction in the pain score assessed by the 10-cm Visual Analogue Scale compared to baseline score. Results In Gabapentin group, pain was signifcantly reduced at 12 and 24 weeks (mean = 5.12 ± 0.67 and 3.72 ± 0.69, respec- tively) than in placebo group (mean = 5.9 ± 0.92 and 5.5 ± 1.13, respectively); this diference was signifcant. At 24 weeks, there was signifcantly higher proportion of patients reporting 30% or more reduction in pain scores; 19 out of 20 patients (95%) in Gabapentin group compared to 8 out of 14 patients (57.1%) in placebo group. -
Pediatric Pain Management
Pediatric pain management An individualized, multimodal, and interprofessional approach is key for success. By Sharon Wrona, DNP, PMGT-BC, CPNP, PMHS, AP-PMN, FAAN, and Michelle L. Czarnecki, MSN, PMGT-BC, CPNP, AP-PMN ACCORDING to the Healthcare Cost and Uti- lization Project, more than 5,000,000 children in the United States had a hospital stay in 2017. Many of them experienced some type of pain. Pain has an immense impact on the mind and body. In addition to the physical sensation of pain, effects include emotion- al suffering, pulmonary complications, de- creased mobility, poor sleep, immune impair- ment, reduced quality of life, economic costs, and a potential for developing persistent (chronic) pain syndromes. Despite advances in care, many children continue to experience significant pain because of undertreatment and inadequate pain management after surgery. Sparing children the short- and long-term ef- fects of pain requires early recognition and CNE 1.4 contact treatment. hours Nurses are critical to pain prevention, recog- nition, and treatment in children. They’re with LEARNING O BJECTIVES patients more than any other healthcare pro- 1. Identify strategies for assessing pain in children. fessionals and have the opportunity to assess 2. Discuss nonpharmacologic pain interventions for children. pain throughout their shift. When pain is diag- 3. Describe pharmacologic pain interventions for children. nosed, the nurse can start planning which in- The authors and planners of this CNE activity have disclosed no relevant terventions are most appropriate for individual financial relationships with any commercial companies pertaining to this patients. After interventions are implemented, activity. See the last page of the article to learn how to earn CNE credit. -
Needle-Free Electroacupuncture for Postoperative Pain Management
Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine Volume 2011, Article ID 696754, 7 pages doi:10.1155/2011/696754 Research Article Needle-Free Electroacupuncture for Postoperative Pain Management Daniel Lee,1 Hong Xu,1 Jaung-Geng Lin,2 Kerry Watson,1 Rick Sai Chuen Wu,2 and Kuen-Bao Chen2 1 School of Biomedical and Health Sciences, Victoria University, Melbourne, VIC 8001, Australia 2 Department of Anesthesiology, China Medical University Hospital, Taichung 40447, Taiwan Correspondence should be addressed to Hong Xu, [email protected] Received 17 January 2011; Accepted 24 March 2011 Copyright © 2011 Daniel Lee et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This study examined the effects of needle-free electroacupuncture, at ST36 on postoperative pain following hysterectomy. Based on a double-blind, sham and different intervention controlled clinical experimental design, 47 women were randomly allocated to four different groups. Except for those in the control group (Group 1, n = 13), a course of treatment was given of either sham (Group 2, n = 12), high-frequency stimulation (Group 3, n = 12), or low-frequency stimulation (Group 4, n = 10). All groups were assessed during the postoperative period for 24 hours. The Visual Analogue Scale was used to determine the amount of perceived pain felt by each subject. Differences were found between the means postoperatively at three, four, eight, 16 and 24 hours. Post hoc comparison tests indicated that Group 4 was significantly different from Groups 1, 2, and 3 at 24 hours. -
The Use of Box-Counting Method in the Interpretation of Visual Analogue Scale Scores
The use of box-counting method in the interpretation of Visual Analogue Scale scores Thamer Ahmad A.K. Altaim1*, A.A. LeRoux2 1 Physiotherapy Department, College of Applied Medical Sciences in Qurayyat, Jouf University, Post code: 77454, Saudi Arabia. 2Longhand Data Limited, Wellburn, York, YO60 7EP, United Kingdom. Correspondence: Thamer Ahmad Abdul Kareem Altaim. Physiotherapy Department, College of Applied Medical Sciences in Qurayyat, Jouf University, Post code: 77454, Saudi Arabia. Email: [email protected]. ABSTRACT Clinicians in their clinical practices face great amounts of difficulties interpreting scores obtained from the pain outcome measures. In spite of long-standing critiques of visual analogue scales (VAS) for pain, no alternative method of measurement has been proposed, and researchers and clinicians have had no alternative to continue using this scale. This study proposed a method which would provide valid measurements on a VAS, one of the most commonly used outcome measures with a particular reference to the 10-cm version of VAS for pain. The method was the box-counting method. The integration of this new method in the interpretations of a patient’s sensation of pain would not only enable clinicians interpret measurements, but also it would help in planning or delivering treatments. The proposed method provided the certainty of the accuracy of a clinical interpretation of a score on the scale. Keywords: Pain outcome measure, visual analogue scale, box-counting method. using the 10-cm Visual Analogue Scale for Pain. Problems in Introduction doing so arise from the uncertainty of the accuracy of a clinical interpretation of a score on the scale. -
Pain Management
PAIN MANAGEMENT A Practical Guide for Waitemata District Health Board’s Healthcare Professionals 1st Edition Developed by Waitemata Pain Services, Department of Anaesthesiology and Perioperative Medicine, and Department of Pharmacy Waitemata DHB, Auckland, New Zealand CONTRIBUTORS TO THIS EDITION Dr Michal Kluger Anaesthesiologist & Pain Physician Anaesthesiology & Perioperative Medicine I WDHB Dr Glenn Mulholland Specialist Anaesthetist & Clinical Lead Acute Pain Service Anaesthesiology & Perioperative Medicine I WDHB Ms Christine Sherwood Clinical Pain Nurse Specialist Anaesthesiology & Perioperative Medicine I WDHB Ms Claire McGuinniety Surgical Team Leader Pharmacist Pharmacy I WDHB Staff who contributed to the publication of this resource: Ms Lourensa Bezuidenhout, Ms Mandy McGowan and Dr Jerome Ng I WDHB DISCLAIMERS Although great care has been taken in compiling and checking the information given in this publication to ensure that it is accurate, the authors, editor and publisher shall not be responsible for the continued currency of the information or for any errors, omissions or inaccuracies in this publication. Waitemata DHB gives no warranty or assurance, and makes no representation as to the accuracy or reliability of any information or advice contained, or that it is suitable for your intended use. Subject to any terms implied by law which cannot be excluded, in no event shall Waitemata DHB be liable for any losses or damages, including incidental or consequential damages, resulting from use of the material or reliance on the information. The resource provides links to external internet sites. These external internet sites are outside the Waitemata DHB’s control. It is the responsibility of the user of the resource to make their decision about the accuracy, currency, reliability and correctness of information found. -
Acute Pain Management
Acute pain management {Color index: Important★| Notes | Book | 433 Notes | Extra | Editing File} Objectives: ➢ Not given Done by: Luluh Alzeghayer & Munerah alOmari. Revised by: Dalal Alhuzaimi PAIN: ● It’s an un unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.1 ● Pain is the fifth vital sign ● Pain is subjective and difficult to quantify. ● The management of pain is a multidisciplinary team effort involving physicians, psychologists, nurses, and physical therapists. ● Unrelieved pain is morally and ethically unaccepted. GOAL OF PAIN TREATMENT: ● Improve quality of the pt . ● Facilitate rapid recovery & return to full function . ● Reduce morbidity . ● Allow early discharge from hospital. Cost effective for both hospital and patients. 1. Acute pain (see here) ● Caused by noxious stimulation due to: injury, a disease process or abnormal function of muscle or viscera ● Recent onset, - Limited duration, - Has a causal relationship, ● It is nearly always nociceptive “ he can point the site of pain”. MCQ! ● Nociceptive pain serves to detect, localize and limit the tissue damage. ● Acute pain plays a useful positive physiological role by providing a warning of tissue damage. ● Postoperative pain is a type of “Acute Pain”23 1 International association of study of pain 1979 2 Pain following surgery is usually relatively short lived and significantly reduced in intensity by 48–72 hours. 3 Although much of acute pain is postoperative, there are many other causes: preoperative surgical (renal colic, peritonitis), medical (acute MI) and trauma (rib fractures). Types of acute pain: imp Type 1. Somatic 2. Visceral: Subtypes ● Superficial: ● Deep: ● Visceral: ● Parietal: True localized or Referred Localized or Referred Origin Nociceptive input from Arise from Muscles, Due to disease process, abnormal function of internal skin, subcutaneous Tendons and Bones organ or its covering, e.g. -
11 Abstract Efficacy of Transcutaneous Electrical
EFFICACY OF TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS) IN TREATMENT OF NEUROPATHIC PAIN IN PATIENTS WITH DIABETIC NEUROPATHY Anjan Desai1, Khushbu Desai2 ijcrr 1SPB Physiotherapy College, Surat, Gujarat Vol 04 issue 09 2Nanduba Medical Centre, Surat, Gujarat Category: Research Received on:12/04/12 Revised on:16/04/12 E-mail of Corresponding Author: [email protected] Accepted on:20/04/12 ABSTRACT Introduction: Diabetic Neuropathy is a peripheral nerve disorder caused by diabetes that leads to pain in periphery. Many patients are limited in their physical activity by pain. The study conducted to assess the effect of Transcutaneous Electrical Nerve Stimulation (TENS) application for reduction of pain in patients with diabetic neuropathy. Aim of study: The main objective of this study is to compare the effect of TENS on Diabetic Neuropathy patients in reduction of pain and improving single limb stance. Materials and Methodology: Study Design: An experimental comparative study. Sample Selection: A sample of 30 patients diagnosed as diabetic neuropathy were taken from after giving due consideration to inclusion and exclusion criteria. Sample size: Total 30 including Control Group (Group A): The patients in this group were given therapeutic exercise training only and Experimental Group (Group B): The patients in this group were given treatment with TENS application and therapeutic exercise training. Inclusive Criteria: Patients of diabetic neuropathy affecting unilateral lower limb defined as ≥ 50% loss of strength and sensation of foot relative to non-affected side and complain of pain duration ≥ 5 months. Exclusion Criteria: Patients with age group between the 50-60 years and Patients with other pathological conditions of foot i.e. -
The Effect of Transcutaneous Electrical Nerve
Short Communication Annals and Essences of Dentistry 2020 Vol.12 No.2 Dental Forum 2020: The effect of transcutaneous electrical nerve stimulation on pain control and anxiety reduction during dental procedure in children 9-14 year’s old - Nina Cebalo - University of Zagreb Nina Cebalo University of Zagreb, Croatia The aim of the study is to analyse the effusiveness of the measuring stress levels with stress-quesonnaires in patients will Transcutaneous Electrical Nerve Smulaon on in decreasing pain give a broader view of connected on and the impact of and anxiety during a dental procedure. The method of psychological stress on the manifestos of anxiety and pain Transcutaneous Electroneurosmula on is based on the principle control. of Electro analgesia, where smulaon of nerve fibers occurs. Smulaon of the A fibers blocks C fibers responsible for Pain has been unchanged tormentor of mankind since time transmission of pain at higher levels of the nervous system. immemorial. Techniques used to control pain are broadly Transcutaneous Electrical Nerve Simulator (TENS device) divided into pharmacological and non-pharmacological works on reduce on of acute and chronic pain, stress, tension, methods. Most common pharmacological means to curb pain in poor circular on and fatigue. Similarly, it can be used to manage dentistry is the use of local anesthesia during dental procedures pain during various dental procedures, as well as pain due to and analgesics for the postoperative pain. Use of local various conditions affecting the maxillofacial region. It can also anesthesia instills fear in a many patients as it requires the use be used as a distract on or placebo mechanism in order to of the ‘horrifying’ syringe. -
Assessment of Pain
Assessment of Pain Assessment of Pain Author: Ayda G. Nambayan, DSN, RN, St. Jude Children’s Research Hospital Content Reviewed by: Nursing Education Department, International Outreach Program, St. Jude Children’s Research Hospital Cure4Kids Release Date: 1 September 2006 Basic pain assessment is a simple task; however, the assessment of pain in children and adolescents with cancer may be more complex. Matters that can complicate pain assessment in this population group may include the inability of the child to verbalize the pain, the use of proxy reports (A – 1) by parents and caregivers, the lack of training of clinicians in the use of pain assessment tools appropriate for the age and developmental level of the patient and the underestimation of the patient’s pain, especially after he or she has been given an analgesic (Romsing et al., 1996; Manne et al., 1992; Miller, 1996). Common Causes of Pain in Pediatric Patients with Cancer Pain may occur as a result of cancer or other factors (A – 2); not all pain that a child or adolescent expresses is due to his or her cancer. Like adults, children and adolescents with cancer may have pain that is due to the following. Procedures such as venipuncture, bone marrow aspiration, biopsy and lumbar puncture Causes related to cancer, e.g., tumor enlargement, ischemia, metastasis, oncologic emergencies Other causes unrelated to cancer, e.g., accidental trauma. Cancer pain in children and adolescents and its intensity depend upon the type of cancer, the extent (or stage of the disease) and the patient’s tolerance to pain. Persistent cancer pain may be due to enlargement of the tumor and the pressure of the tumor on the body organs, nerves or bones. -
East Midlands Ambulance Service NHS Trust Is Committed to Providing High Quality, Safe and Effective Care to All Service Users
Pain Management Standard Operating Procedure Links The following documents are closely associated with this policy: Medicines Management Policy Drug Management Procedure Implementation of National Guidance and Information Policy Community First Responder Policy Medical First Responder SOP Untoward Incident Reporting Procedure End of Life Clinical Management Procedure Document Owner : Medical Director Document Lead: Consultant Paramedic Document Type: Standard Operating Procedure For use by: All clinical/operational staff Equality Impact Assessment September 2014 This document has been published on the: Name Date Library (EMAS Public Drive) 17 August 2017 Intranet 17 August 2017 Pain Management Standard Operating Procedure Page: 1 of 10 Document ID: OR/113.2 Version: 2.0 Date of Approval: 19 July 2017 Status: Final Approved by: Clinical Governance Group Date of Review: July 2019 Document Location Version Control If using a printed version of this document ensure it is the latest published version. The latest version can be found on the Trust’s Intranet site. Version Date Approved Publication Date Approved By Summary of Changes Clinical Governance 1.0 22/07/15 02/10/15 New procedure Group Amended title Updated roles Clinical Governance 2.0 19 July 2017 17 August 2017 Updated monitoring group Group Addition of Wong-baker faces assessment tool Removal of diclofenac Pain Management Standard Operating Procedure Page: 2 of 10 Document ID: OR/113.2 Version: 2.0 Date of Approval: 19 July 2017 Status: Final Approved by: Clinical Governance Group Date of Review: July 2019 Contents Page 1. Introduction 4 2. Objectives 4 3. Scope 4 4. Definitions 4 5. Responsibilities 4 6.