What a Pain in the ER

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What a Pain in the ER : 

What a Pain in the ER Brian Votaw December 3, 2010 Clinical Project for UVRMC Emergency Department

Pain Defined : 

Pain Defined The International Association for the Study of Pain define it as, an unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of such damage. Pain includes not only the perception of an uncomfortable stimulus but also the response to that perception.

How do nurses view the patients pain? And how does the patient view their own pain? : 

How do nurses view the patients pain? And how does the patient view their own pain? http://www.youtube.com/watch?v=xtK7yzRC_8A

UVRMC Pain Protocols : 

UVRMC Pain Protocols

Initial Assessment : 

Initial Assessment Obtain: pain intensity, BP, HR, RR, O2 sat, degree of sedation by (NAMDU) score Establish patient’s pain management goal

Initial Assessment Cont. : 

Initial Assessment Cont. Use COLDEER as a tool, document an assessment C-Character O-Onset L-Location D-Duration E-Exacerbate R-Relief R-Radiation

Pain Intensity : 

Pain Intensity Numerical 0-10 Faces FLACC

Ongoing Assessement : 

Ongoing Assessement Every 2 hours until pain management goal is attained, then every 4 hours Within 60 minutes of medication intervention Respiratory rate and degree of sedation (if receiving opioids) For IV push, at the time the medication peaks Q 4 hours for chronic pain

Goals for this project : 

Goals for this project Remind staff of the need to continually assess pain Document pain assessments not just the medication being given Monitor the patients’ vital signs more closely Follow procedures put in place by facility Be the patient advocate by practicing safe pain management

How to remind staff of pain protocols : 

How to remind staff of pain protocols Place flyer with the UVRMC pain protocols in highly visible areas Employee lounge Restrooms Employee bulletin board Patient rooms

Give a guide to each staff member : 

Give a guide to each staff member

Conclusion : 

Conclusion Using the “fifth vital sign” we can follow JCAHO’s standards that “pain is assessed in all patients” and that “patients have the right to appropriate assessment and management of pain.”

Thank you… now go medicate your patients’ little hearts out! But follow pain protocols : 

Thank you… now go medicate your patients’ little hearts out! But follow pain protocols

References : 

References Smeltzer S, Bare B, Hinkle J, Cheever K. (2008). Brunner and Suddarth’s Textbook of Medical-Surgical Nursing, Eleventh Edition. Philadelphia, Pennsylvania: Lippincott Williams and Wilkins.