Week 7 - pain and comfort

Pain

an unpleasant sensory and emotional experience

comfort

holistic prevenetion and ease of suffering

acute pain

occurs suddenlu and is typically linked to specific event such as a surgical incision

chronic pain

pain lasting more than 3 months and may last for years— may emerge from underlying pathologies such as cancer or osteoarthritis

risk factors of pain

• pts with comorbidities

• elderly

• genetics— disorders and diseases associated with discomfort; mutations affecting perception of pain

• women— report higher prevalence of chronic pain than men, lower pain threshold → hormones account for some of this

• cultural/religious conviction may pose barrier for reporting pain

• income and education affect access to pain treatment

• mental illness common co-morbidity with chronic pain

• anyone who cannot report pain is at risk for undertreatment

• traumatic injury, critical illness, surgical procedure, multiple acute/chronic conditions associated with pain

OLDCARTS pain assessment

Onset - when the pain started

Location - state or point to the area of pain on the body

Duration - has the pain been constant or intermittent, length of pain episodes

Characteristics - allow pt to use their own words to describe the pain

Alleviating and Aggravative - what makes the pain better, what makes it worse

Radiation - where does the pain travel

Treatment - what has the pt taken or done to treat the pain

Severity/Score - intensity of the pain; on scale of 1-10, Wong-Bake FACES, verbal descriptive scale

3 analgesic groups

1. Nonopioid analgesic - acetaminophen, nonselective NSAIDS, COX-2 selective NSAIDS

2. Opioid analgesics - morphine, fentanyl, hydromorphone, oxycodone

3. Adjuvant analgesics - local anesthetics, anticonvulsants, antidepressants