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'Pain in the ICU' report suggests comprehensive approach
Date:4/7/2009

rginia Commonwealth University Medical Center, Richmond, VA. "An interdisciplinary critical care team who uses standard and alternative methods of pain assessment, evaluation, and management is essential for optimal patient care."

Assessing Pain In Critically Ill Patients

Standard tools for pain assessment and evaluation, which typically rely on a patient's own verbal report, may be ineffective for critically ill patients who are unable to communicate. In these situations, the critical care team can use alternative methods for pain assessment, including the following:

  • Patient Risk ProfileThis tool identifies the patient's risk of pain prior to a procedure and allows the team to administer preemptive pain management, whereby decreasing the incidence of pain.
  • Nonverbal CommunicationPatients who cannot speak or have difficulty speaking may be able to point or blink when referring to a pain scale.
  • Analgesic TrialTo verify the presence of pain, the ICU team can administer a low dose of first-line analgesic followed by observation of the patient's pain-related behaviors.
  • Surrogate ReportingIf patients are unable to communicate, the ICU team can use "surrogate reports" from family members who may be able assess a loved one's pain based on history.

"Critical care professionals have come to value family members of patients as an integral part of the care process," said Kathleen Puntillo, RN, CNS, DNSc, FAAN, lead author of the Evaluation article and Co-Director of the Critical Care/Trauma Program, Department of Physiological Nursing, University of California, San Francisco, CA. "Although family members' surrogate pain reports may be helpful, their effectiveness still requires more research."

Managing Pain in Critically Ill Patients

Organ failure, sepsis, and other medical complications can make it difficult to manage pain in the critically ill. The use of opioids or related medic
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Contact: Jennifer Stawarz
jstawarz@chestnet.org
847-498-8306
American College of Chest Physicians
Source:Eurekalert

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