Clinical Demonstration: Pain Patient Flashcards
What does SOCRATES stand for?
- Site
- Onset
- Character
- Radiation
- Associated symptoms
- Time
- Exarcebating/Alleviating factors
- Severity
What can cause a headache?
- Tension
- Glaucoma
- Meningitis / Encephalitis
- Cluster headaches
- Trigeminal neuralgia
- Medication misuse
- Subarachnoid haemorrhage
- Tooth ache
- Migraine
- Giant cell arteritis
What are some causes of muscular pain?
- Injury
- Posture
- Rheumatological (polymyositis, dermatomyositis)
- Fibromyalgia (diffuse muscular pain over body)
- Infections
- Rhabdomyolysis
- Nutritional deficiency
What causes joint pain and helps alleviate it?
- Arthritis (osteo, rheumatoid, injury)
- Topical agents (NSAIDs, menthold, capsaicin)
- Glucosamine, chondroitin
- Steroid injections
- DMARDs
What is consequential regarding back pain?
- Very common
- Big contributor to loss of earnings
- Affects ADLs
- Depression, anxiety
Can be a RED FLAG
What can help alleviate back pain?
- Non-pharmalogical (physio, heat/ice packs, acupuncture)
- NSAIDs
- Neuropathic agents
- Surgery
What are treatments for fractures?
- Oral - simple, opiates
- Nerve blocks - anaesthetic directly into nerves
- Transdermal patches
- Prevention
What is the cause of visceral pain?
- Inflammation
- Ischemic
- Thrombo-embolic
- Blockage
- Compression
What class of drug is amitriptyline?
TCA - tricyclic antidepressents
What class of drugs are gabapentin and pregabalin?
Anti-epileptic
What is the WHO cancer pain ladder?
The different lines of action on treating pain.
- Non-opioid (eg. paracetamol) + adjuvant
- Opioid (mild-moderate pain) (tramadol, codeine)*
- Opioid (moderate-severe) (morphine)*
*+/- non-opioid, +/- adjuvent
What is patient controlled analgesia (PCA)?
PCA – gives an opiate every time patient presses button, has a lock-out time so can’t keep pressing – prevents overdose. Works well in short-term post-op period. Patient has to be able to use it
Why is post-operative pain management useful?
- Early mobilisation
- allows for better breathing to prevent chest infection
- Helps to identify complications
