Pain Final With K I W I N

Acute and chronic pain Contemporary and alternative treatments

Pain—the definition…. ,[object Object],[object Object],[object Object],[object Object]

Is there a problem? ,[object Object],[object Object],[object Object],[object Object]

Pain assessment: ,[object Object],[object Object]

Common Misconceptions among Elderly and Nurses ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Descriptions of pain: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pain threshold : amount of pain stimulation a person requires before feeling pain. Pain tolerance : the highest intensity of pain that the person is willing to tolerate.

The categories of pain: ,[object Object],[object Object],[object Object],[object Object]

Effects of acute pain: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Effects Chronic Pain: ,[object Object],[object Object],[object Object],[object Object],[object Object]

Pathophysiology of pain ,[object Object],[object Object],[object Object],[object Object]

Pathophysiology of pain: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Nociception (or pain perception) can be divided into four phases: ,[object Object],[object Object],[object Object],[object Object]

Descending control system: ,[object Object],[object Object],[object Object],[object Object]

Spinal Cord Modulation: How can the gate be closed? ,[object Object],[object Object],[object Object],[object Object]

Gate-control theory: may decrease amount pain medication needed

What alternative therapies can close the gate? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Let’s try an experiment…. ,[object Object],[object Object]

Why have a pain scale? ,[object Object],[object Object],[object Object],[object Object],[object Object]

So how do we deal with the problem of pain? ,[object Object],[object Object]

Other pain scales are just numeric

Alternative therapies which may close the gate: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pharmacological management: ,[object Object],[object Object],[object Object],[object Object],[object Object],Taken from Alexander, L. L. (2006). Pain management, palliative care and treatment of the terminally ill

Analgesic ladder in action: ,[object Object],[object Object],[object Object],Alexander, L. L. (2006). Pain management, palliative care and treatment of the terminally ill

WHO 3-step Analgesic ladder COX-2, Aspirin, Acetaminophen, Diclofenac, Ibuprofen, Tenoxicam, Panadeine, Nurofen. Pain rating 1-2-3 Non-opioid (mild pain) +/- adjuvant Opioid (mild to moderate pain) +/- non-opioid adjuvant +/- adjuvant Codeine, Propoxyphene, Tramadol, Sevredol, DHC Continus, Dihydrocodeine tartate. Pain rating: 4-5-6 Opioid (moderate to severe pain) +/-non-opioid, +/-adjuvant Step 1 Step 2 Step 3 Oxycodone, Morphine, Fentanyl, Pethidine Ketamine Pain rating 7-10

Breakthrough pain ,[object Object],[object Object],[object Object],[object Object],Alexander, L. L. (2006). Pain management, palliative care and treatment of the terminally ill

Pain management through medication and/or neurosurgery ,[object Object],[object Object],[object Object],[object Object],Kastinias, P., S.E. Kianda, Robinson, S. (2006).

Manage side-effects opiates: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Alexander, L. L. (2006). Pain management, palliative care and treatment of the terminally ill

Narcotic analgesics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

KIWIN™ Classification PROBLEM IDENTIFICATION Domain: Physiological domain Problem: 24. Pain Priority: High Modifier: Individual Modifier: Actual Signs and Symptoms: 01. expresses discomfort/pain 04. restless behaviour 05. facial grimaces

KIWIN™ Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

KIWIN™ Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pain Final With K I W I N

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Pain Final With K I W I N