This document discusses pain management strategies for first aid situations. It explains that pain is commonly why people seek medical care but first aid training focuses more on injuries than pain relief. Correctly treating injuries can sometimes reduce pain as a side effect. Additional pain management strategies discussed include medication options like NSAIDs and opioids, as well as non-medicated options like RICE (Rest, Ice, Compression, Elevation), positioning, reassurance, and distraction. The document provides details on assessing pain using the PQRST method and differentiating between nociceptive and neuropathic pain.
Pain definition, Pain pathways, pain modulation, the endorphin system, Types of Pain, current trend of Drugs used for pain management. New Drugs for pain
In this presentation I have tried to explain in brief about pain management, different types of pain, its diagnostic criteria, its physiology, and its treatment approaches both pharmacological and non pharmacological
Pain definition, Pain pathways, pain modulation, the endorphin system, Types of Pain, current trend of Drugs used for pain management. New Drugs for pain
In this presentation I have tried to explain in brief about pain management, different types of pain, its diagnostic criteria, its physiology, and its treatment approaches both pharmacological and non pharmacological
SpAn harus memberi waktu untuk pengelolaan nyeri
SpAn harus mampu mengelola nyeri dengan memilih cara yang paling aman, paling efektif dan paling ekonomis
Berperan aktif pada acute pain
Berperan, minimal partisipatif, dalam chronic pain
Berperan utama pada interventional pain management
pain. Medical Surgical Nursing ......pptxPatelVedanti
Pain is a complex, multidimensional phenomenon. Everyone has experienced some types or degrees of pain. Pain is the most common reason for physician and also common problems faced by nurses when they are dealing with the patients.
The word pain is derived from the Latin word ‘Poena’ which means punishment. It is a major symptom in many medical conditions, and can significantly interfere with a person's quality of life and general functioning.
Pain motivates us to withdraw from potentially damaging situations, protect a damaged body part while it heals, and avoid those situations in the future.
Most pain resolves promptly once the painful stimulus is removed and the body has healed, but sometimes pain persists despite removal of the stimulus and apparent healing of the body; and sometimes pain arises in the absence of any detectable stimulus, damage or disease.
The International Association for the Study of Pain's widely used definition states:
"Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage".
The processes in the body that are involved in the perception of pain are called "nociception."
Mount castle defined pain as “that sensory experiences evoked by stimuli that injure or threaten to destroy tissue, defined introspectively by every man as that which hurts”.
The International Association for the Study of Pain (IASP) classification system describes pain according to five categories:
Duration And Severity,
Anatomical Location,
Body System Involved,
Cause, And
Temporal Characteristics (Intermittent, Constant, Etc)
Acute pain lasts a short time, or is expected to be over soon. The time frame may be as brief as seconds or as long as weeks.
Chronic pain may be defined as pain that lasts beyond the healing of an injury, continues for a period of several months or longer, or occurs frequently for at least months and is more difficult to manage.eg-rheumatoid arthritis
Cutaneous or superficial pain- it is directly precised &readily localized i.e. patient can indicate exactly where it hurt.
Referred pain- pain felt at a site distinct from site of pain. eg-cardiac pain is present in the heart, but felt in the left arm
Intractable pain- persistent, severe pain that cannot be effectively controlled by the usual medication is referred to as “Intractable pain”.
Localized pain- Localized pain arises directly from the site of the disturbance.
Differentiation of neurolapatic pain- severs pain caused by nervous system damage, when the flow of afferent nerve impulse has been partially or completely interrupted. eg accident.
Pain of muscular or bonny origin- the muscular ischemia of intermittent claudication(a in commonly in the legs or arms that comes on with walking or using the arms.) & occlusion vascular induce pain in the extrimities. eg joint pain
Pain can be described as sharp or dull with a burning sensation in the relevant body parts. It might vary from being steady to fluctuating. The intensity and nature of the pain can vary from one body part to another.
People with chronic pain or illnesses can experience a variety of emotions including anxiety, grief, guilt, depression and anger. Accepting the condition and integrating it into daily life requires dealing with the losses and resentments and deciding how to live a meaningful life despite the condition.
Comprehensive description of pain pathways which covers related definitions, benefits, theories, classification and mechanism of pain with factors that affect pain and diagnosis of pain. Also covers assessment and management of pain along with brief description of ascending and descending pain pathways.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
2. Stratford Upon Avon First Aid 2
Pain and Pain Management
• Pain is the most common symptom
causing patients to seek medical attention
yet most formal training is primarily
concerned with treating injuries and illness
with hardly any time spent on how to
manage the pain itself.
3. Stratford Upon Avon First Aid 3
Pain and Pain Management
• In many instances correct treatment of the
injury or illness will reduce pain as a
consequence; cooling a burn, stabilising a
joint injury or correctly positioning a
casualty with chest pain, for example, will
in effect reduce pain as well as correcting
the cause for concern.
4. Stratford Upon Avon First Aid 4
Pain and Pain Management
• Sometime this is not enough, sometimes
the cause is obvious but sometimes the
casualty just presents with ‘pain’. No
apparent injury, no history of illness. How
do you treat that?
• Sometimes, even after initial treatment,
the casualty is still in pain. Definitive care
is over 12 hours away. What do we do
then?
5. Stratford Upon Avon First Aid 5
Pain and Pain Management
• Pain in itself is not life threatening but pain
can cause physiological changes in blood
pressure, breathing and pulse. This is
interesting but the main reason that I want
to manage a casualty’s pain, is for
compliance:
• A pain-free casualty will be
• more compliant
6. Stratford Upon Avon First Aid 6
Pain and Pain Management
• more willing to engage in their own
treatment
• less dependent on others
• easier to move and transport
• more willing to accept potentially painful
procedures such as examination or wound
cleaning, for example.
7. Stratford Upon Avon First Aid 7
Pain and Pain Management
• Better rested with less disturbed sleep,
less stressed and generally a nicer person
to be around. This is especially important
in remote areas when living in small
groups or teams and in confined areas!
8. Stratford Upon Avon First Aid 8
What is Pain?
• Pain has two primary
etiologies: nociceptive and neuropathic.
The difference is whether the pain
stimulus comes from a nerve receptor,
intended to sense pain, touch,
temperature, or pressure (nociceptive); or
if the pain stimulus comes directly from
injury to the nerve itself (neuropathic).
9. Stratford Upon Avon First Aid 9
What is Pain?
• Nociceptive pain, for example, is the pain
that occurs when you hit your thumb with a
hammer. The impact stimulates the nerve
receptors, sending pain signals to the
brain. If you push on the area of pain, it
will make the pain worse.
10. Stratford Upon Avon First Aid 10
What is Pain?
• Neuropathic pain, on the other hand, is
radiating pain that occurs when a nerve
itself is injured. For example, the casualty
may have ruptured a disk in their lower
back, and that disk is now compressing
the left L5 nerve root of the sciatic
nerve. As a result, they will have pain that
radiates down the back of their leg to their
foot.
11. Stratford Upon Avon First Aid 11
What is Pain?
• When you push on the areas of apparent
pain – the foot - it does not cause more
discomfort because the problem is at the
disc, not where the pain is presenting.
12. Stratford Upon Avon First Aid 12
What is Pain?
• Nociceptive pain is easily managed with
non-steroidal anti-inflammatory drugs
(NSAIDs),paracetamol (acetaminophen in
the US) and opioids. Neuropathic pain
does not respond to these usual pain
relievers, making it much harder to control.
13. Stratford Upon Avon First Aid 13
Assessing Pain
• Pain is incredibly subjective and the term
‘pain’ is wildly vague. For the casualty to
say “I’m in immense pain!” tells me nothing
other than something is not normal. A
critical, structured approach can help
gather more detailed and
relevant information:
PQRST
14. Stratford Upon Avon First Aid 14
Provocation
• What caused the pain?
• Does anything aggravate the pain?
15. Stratford Upon Avon First Aid 15
Quality
• Can you describe the pain? Is it a dull
ache, a sharp stabbing pain, a vice-like
gripping pain or a numb tingly pain, for
example?
16. Stratford Upon Avon First Aid 16
Radiates or Refers
• Some pain radiatesoutwards; is the pain
spreading? Neuropathic pain will ‘refer’
i.e. the pain is felt elsewhere. A common
example is the pain felt in the tip of the left
shoulder pain which can be indicative of
an ectopic pregnancy. This would be
worth considering if the casualty was a
sexually active female of child-bearing
age. Less so if your casualty is male.
17. Stratford Upon Avon First Aid 17
Severity
• Because pain is so subjective, to describe
the intensity is practically worthless; a
paper-cut can be agony to one person or a
mild annoyance to another. A more
representative assessment would be to
ask the casualty to score the pain out of
10 (10 being the worst possible
pain). This again is a worthless value on
its own as it is simply one person’s
opinion.
18. Stratford Upon Avon First Aid 18
Severity (Continued)
• However, if this question is repeated a
change in the value stated will indicate an
increase or decrease in pain. This is
particularly useful if dealing with casualty’s
for an extended period of time, after
treating an injury or after administering
pain relief.
19. Stratford Upon Avon First Aid 19
Time
• When did it start?
• Is it constant or does it come and go?
20. Stratford Upon Avon First Aid 20
Assessing Pain
• The answers you get may enable you to
make an informed decision or they may
not mean anything to you.
• They will mean something to someone so
whether you understand the answers or
not, all communication is documented
and handed over to definitive care.
21. Stratford Upon Avon First Aid 21
Mechanisms of Pain Control
• There are several methods we can employ
to help reduce pain:
• Non-medicated pain control:
– Minimize and control swelling of the tissues
by RICE
– Additional techniques
• Medicated pain control:
– Analgesics
– Specific medications
22. Stratford Upon Avon First Aid 22
Non-Medicated Pain Control
• Pain can be reduced, to some degree,
without the need of medications. The
most effective and widely used techniques
is the application of RICE
• Rest: Rest or completely immobilise the
injured area to minimize movement.
23. Stratford Upon Avon First Aid 23
Non-Medicated Pain Control
• Ice: Apply cool compresses to the affected
area to cause vasoconstriction, reducing
swelling and thus reducing pain. This also
minimizes any further bleeding into the
damaged tissue. Ice is a metaphor for
cool – NEVER apply ice directly to skin.
24. Stratford Upon Avon First Aid 24
Non-Medicated Pain Control
• If you have ice available (from a drinks
bucket, a bag of frozen peas or even snow
or ice itself), wrap the ice in something wet
which will conduct heat quickly but will
reduce the chance tissue damage.
25. Stratford Upon Avon First Aid 25
Non-Medicated Pain Control
• A regime of a maximum of 15 minutes
cooling in every hour is used to ensure
vasoconstriction does not lead to frostbite
in the effected limb and, furthermore,
alternate cooling and rewarming is more
effective than continual cooling as the
affected area also needs a good supply of
blood to remove waste products and
promote healing.
26. Stratford Upon Avon First Aid 26
Non-Medicated Pain Control
• Comfortable position: Historically the
“C” has always stood for Compression but
there are inherent risks in applying
compression dressing to a swollen injury
or injury which may continue to swell.
27. Stratford Upon Avon First Aid 27
Non-Medicated Pain Control
• This is largely academic as the casualty
will probably not allow you to apply a
compression dressing, in which case
allowing them to adopt the most
comfortable position is far more beneficial
in terms of reducing pain and promoting
recovery. Don’t worry about whether they
should be in a high arms sling or a low
arm sling – bind as you find!
28. Stratford Upon Avon First Aid 28
Non-Medicated Pain Control
• Elevation: Elevate the injured area above
the level of the heart. This lowers the
blood pressure and decreases the rate
that blood leaks into the damaged tissue
and further reduces swelling.
• Addition techniques
• In addition to RICE, pain may also be
managed by:
29. Stratford Upon Avon First Aid 29
Non-Medicated Pain Control
• Positioning – There are many recognised
positions for a casualty which are said to
reduce pain or promote recovery with
exciting names such
as Trendellenberg and Reversed
Recumbent. The casualty will adopt their
own position. Most people with abdominal
pain will bring their knees up and curl up in
the foetal position.
30. Stratford Upon Avon First Aid 30
Non-Medicated Pain Control
• Casualties suffering with chest pain or
breathing conditions will prefer NOT to lie
down, so don’t make them. Support the
casualty in the position they adopt.
31. Stratford Upon Avon First Aid 31
Non-Medicated Pain Control
• Reassurance – Pain is a physiological
response to either the stimulus of nerve
receptors or the presence of chemical
mediators but the perception of pain can
be exacerbated or suppressed depending
on the level of emotional support provided
to the casualty. Do not underestimate the
value of emotional support.
32. Stratford Upon Avon First Aid 32
Non-Medicated Pain Control
• Distraction – By the same token, do not
do everything for the casualty. The best
way to make someone feel helpless is to
treat them as though they are. Engaging
the casualty in their own treatment and
keeping them occupied is an effective
method of distraction.
• Traction can relieve pain but training is
essential.
33. Stratford Upon Avon First Aid 33
Medicated Pain Control
• There is a lot if myths which are still
promulgated in society in general and on
some formal training courses:
• It is not illegal to give an adult a simple
pain relief such as aspirin
or paracetamol as long as it is done
correctly. It is not illegal to give a child
medication as long as it is both done
correctly and there is parental consent.
34. Stratford Upon Avon First Aid 34
• To leave tablets in front of a casualty and
say "I'm just going to leave the room, if
you choose to take some I won't say a
word, nudge nudge wink wink“
• DOES NOT ABSOLVE YOU OF
RESPONSIBILITY.
35. Stratford Upon Avon First Aid 35
• Many people think that because we cannot
give pain killers to casualties, if we
suggest they take them themselves there
is no harm done. THIS APPROACH
MAKES YOU NEGLIGENT.
36. Stratford Upon Avon First Aid 36
• If the casualty is in pain, you have asked
appropriate questions, you know there are
no known allergies and they have taken
the medication before, you know what
dose to give them and how often, do so
and write it down.
37. Stratford Upon Avon First Aid 37
• To leave a casualty, who clearly wants
pain relief alone with medication YOU
have presented to them which they
otherwise would not have taken - of
course they are going to take it but this
time nothing is documented or observed.
38. Stratford Upon Avon First Aid 38
• People arrive at A&E complaining of acute
pain. When asked by the Triage
Nurse "Have you taken any pain
relief?" they frequently reply with "No, we
didn't want to mask the pain." Take pain
relief, that is what it is for. Commonly
available over-the-counter pain relief will
not mask acute pain, it will take the edge
of and make things a little more bearable.
39. Stratford Upon Avon First Aid 39
• We have probably all seen or
taken aspirin, paracetamol (acetaminophe
n in the US) or ibuprofen at one time, or
another, being the most widely available
pain killers. What is important is to
understand is that they are not the same:
40. Stratford Upon Avon First Aid 40
Aspirin
• Aspirin
• A mild analgesia that is known for its
additional quality of ‘thinning the blood’. It
doesn’t actually thin the blood but it is
what’s known as a platelet aggregation
inhibitor; it inhibits blood clotting. This can
be used to good effect as prophylactic
medication at altitude or for these with
cardiac problems.
41. Stratford Upon Avon First Aid 41
Aspirin
• Aspirin is also given immediately after a
heart attack to reduce the chance
subsequent heart attacks and reduce the
damage to cardiac muscle 1,2.
• 300mg – 600mg every 6 hours to a
maximum of 4g a day. Take with food and
avoid if there is a history of stomach ulcers
or an allergy to ibuprofen or naproxen.
42. Stratford Upon Avon First Aid 42
Paracetamol
• A much underrated pain relief;
paracetamol is an effective pain killer to
the extent that IVparacetamol is regularly
used in A&E departments where lay-
people would commonly expect much
‘stronger’ pain relief to be used.
43. Stratford Upon Avon First Aid 43
Paracetamol
• The interesting fact about paracetamol is
that it is known to work but no really
understands how, just that it
does! Paracetamol has additional
properties in reducing fever although
paracetamol should not be given to reduce
a fever unless it is over 40oc – the root
cause of the fever needs to be addressed.
44. Stratford Upon Avon First Aid 44
Paracetamol
• Paracetamol – like all drugs – does not
come without warning. Paracetamol is
toxic in comparatively small amounts.
• 500mg – 1g (one to two tablets) every 4-6
hours to a maximum of 4g a
day. Paracetamolshould be avoided
where there is a history of liver problems
45. Stratford Upon Avon First Aid 45
Ibuprofen
• Ibuprofen (or ‘brufen’) is well known as an
anti-inflammatory and therefore ideal for
bone or joint injuries however as platelet
aggregation inhibitor (although to a far
lesser degree thanaspirin) it should be
avoided in the first two days of injury as it
may promote bleeding into the tissue, in
which case start with paracetamol and
add ibuprofen if needed.
46. Stratford Upon Avon First Aid 46
Ibuprofen
• 200mg-400mg 8 hourly – with food – to a
maximum of 1200mg a day.
47. Stratford Upon Avon First Aid 47
Naproxen
• Naproxen is, like ibuprofen, an effective
anti-inflammatory but is better tolerated
with less stomach irritation. Naproxen is
not available over-the-counter in its
standard form but is available under the
trade name Feminax UltraTM.
• 500mg first followed by 250mg 6-8 hours
later. 250mg 8 hourly on the 2nd and 3rd
day.
48. Stratford Upon Avon First Aid 48
Paracetamol + Ibuprofen
• Both ibuprofen and naproxen can be
combined safely to increase the efficacy to
greater effect than some
narcotics. Interestingly the addition
of paracetamol increases the analgesic
effect of both regardless of the doses of
either ibuprofen or naloxone – higher
doses of either in combination
with paracetamol is not proven to increase
analgesic effect.
49. Stratford Upon Avon First Aid 49
Paracetamol + Ibuprofen
• 400mg ibuprofen 8 hourly (to a maximum
of 1200mg in 24hrs) + 1g paracetamol 6
hourly (to a maximum of 4mg in 24 hours)
50. Stratford Upon Avon First Aid 50
Codeine
• Both ibuprofen and paracetamol are
currently available with codeine over-the-
counter. These represent the strongest
openly available analgesics.
• Codeine has a constipative effect so your
casualty may need to consider laxatives if
on codeine for several doses.
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Antihistamines
• Clorpheniramine (PiritonTM) is primarily
used as an antihistamine for the treatment
of mild allergic reactions including hay
fever but also has a mild sedating and
analgesic effect.
52. Stratford Upon Avon First Aid 52
Antihistamines
• In a remote setting, whilst not licensed for
the treatment of
anaphylaxis, chlorpheniramine may be of
benefit from some exhibiting a severe
reaction.
53. Stratford Upon Avon First Aid 53
Antibiotic Creams
• Pain relief will only mask the symptoms of
eye, ear or skin infections so treat the
infection itself.
54. Stratford Upon Avon First Aid 54
Indigestion
• If normal antacids (Gaviscon or Rennie,
e.g.) are not effective, ranitidine can be
used. Read the label.
55. Stratford Upon Avon First Aid 55
Sore Throat
• Typical pastels have no medicine effect
other than activating saliva and tasting
sweet. Dequacaine contains a mild
anaesthetic for the most painful of sore
throats but again, it treats the symptoms,
not the cause which must also be
addressed.