VAO PAIN RELIEF HANDOUT

Transcription

1 HANDOUT AMBULANCE TASMANIA 1

2 Clinical Field Protocols To complete this module, you will need to become familiar with the following clinical protocols: Clinical Approach to a Patient VAO CFP03 Pain Relief VAO CFP03 Pain Relief Chest Pain You will also need to become familiar with the following drug protocols: VAO D005 Aspirin (Acetylsalicylic Acid) VAO D016 Glyceryl Trinitrate (GTN) VAO D017 Methoxyflurane (Penthrane) VAO D029 Oxygen. and the following reference material: VAO RM02 Paediatric Pain Assessment AMBULANCE TASMANIA 2

3 PAIN A sensation of discomfort varying from minor to extreme as a result injury or disease. Pain is not a simple sensation that can be easily assessed and measured. Nurses should be aware of the many factors that can influence the patients overall experience and expression of pain, and these should be considered during the assessment process. CUTANEOUS e.g. cut finger SOMATIC e.g. sprained ankle VISCERAL e.g. appendicitis TYPES OF PAIN ARE: REFERRED e.g. cardiac pain Pain warns of impending tissue damage and usually encourages the individual to seek help Factors involved are: type and origin psychological factors pain threshold oxygen deprivation movement age Methods of pain relief are: re-assurance calming influence explanation of cause and treatment diversion of thoughts removal from situation pharmaceutical pain relief posture (knees up in abdo pain) splinting avoiding pressure over site AMBULANCE TASMANIA 3

4 Questions to ask. Is the pain a primary complaint or a secondary complaint associated with another condition? What is the location of the pain? Does it radiate? What makes the pain better or worse? Does it get worse with movement or certain activities? Is it constant or does it come and go? How long does it last? Have you ever had pain like this before? Have you tried anything to relieve the pain? (e.g. medication, massage, heat/cold, rest/exercise, stretching, eating/not eating ) Describe the character of pain using quality/sensory descriptors for example: aching, burning, sore, pounding, crampy, tight, electric, sharp, crushing, stabbing, throbbing, knot-like, pressing, pinching, pulsing, dull, pins and needles, pricking, shooting, deep, stretching, tender or gnawing Special circumstances: Older adults may use a range of words other than pain to describe their pain experience. A patient who has a cognitive impairment may have difficulty using a variety of pain measurement tools, however simple self-report tools have been shown to be effective. Visually impaired patients may not be able to use a visual analogue scale and may benefit from using a verbal rating scale that is adapted to their needs. Paediatric pain assessment should be appropriate to the developmental level of the child. Pain can be communicated by words, expressions and behaviour such as crying, guarding a body part or grimacing. The QUESTT principles may be useful (see CFP Reference Material). Children less than 3 years or who are unable to communicate can be assessed using the FLACC Scale (see CFP Reference Material).. AMBULANCE TASMANIA 4

5 NILDOOCARRF An acronym for checking pain details on a patient (history) NATURE of the pain- sharp dull deep aching etc INTENSITY score out of ten from no pain (0) to worst imaginable (10) LOCATION where do you feel the pain? DURATION of the current episode time between onset and offset ONSET of the current episode OFFSET of the current episode (may still be present) CONCOMITTANT FACTORS vomiting, sweaty, pale AGGRAVATING FACTORS posture, food intake, medications etc RELIEVING FACTORS posture, food intake, medications etc RADIATION pain or discomfort felt elsewhere FREQUENCY how often has this pain occurred in recent times AMBULANCE TASMANIA 5