1. Brought to you by: Andrea King & Wale
Ojeyinka
Week of
10/5/2015

2. Assess, Prevent,
and Manage Pain

3. Procedures Hurt!
 Most Painful
 Turning 1,2 Chest Tube Removal 2
 Wound Drain Removal 1,2 Arterial Line Insertion 2
 Wound Care 1,2
 Others
 ET Suctioning 1,2 Peripheral Blood Draw 2
 Tracheal suctioning 1,2 Peripheral IV Insertion 2
 Femoral Sheath Removal 1 Positioning 2
 Mobilization 2 Respiratory Exercises 2
 Central Line Removal 1
 1Puntillo K AJCC 2001; 10:238-251
 2Puntillo K AJRCCM, 2014; 89: 39-47.

4. Key Point
 ASSESS & CONTROL PAIN!
 Untreated pain can lead to agitation and delirium.
 Imagine uncontrolled pain leading to respiratory
distress leading to intubation…

5. Assessing Pain: A Stepwise
Approach
Attempt to obtain the patient’s self-report of pain-
GOLD STANDARD
A simple yes or no = valid self-report
1
2
3
4
Look for behavioral changes
NVPS
The family can help to identify pain behaviors
“Assume pain is present”
Attempt an intervention for pain relief
American Society for Pain Management Nursing
Herr K Pain Manage Nurs 2011;12(4): 230-50
* Vital signs should not be used alone for assessment of
pain*

6. Both Spontaneous
Awakening Trial &

8. Key Points
 If the patient meets criteria for SAT then TURN
OFF THE SEDATION!
 Coordinate with RT for SBT