Fleming Acute Pain Flashcards
___ days of therapy is often sufficient
7
What is the backbone of acute pain management?
PRN pain dosing
what must a PRN pain order have on it?
pain scale rating
Opioid naive:
continuous infusion can be set after __ to __ hours of dosing to estimate needs
4, 8
steps to dose opioid naive (continuous infusion):
- add up PRN doses to determine 24 hour requirement
- 50% of 24hr dose can be given continuously
- 10-15% of total CI dose can be given PRN every 2-3hrs
steps for determining acute pain dose in opioid tolerant pt:
- determine equianalgesic dose of home pain regimen
- escalate equivalent dose depending on pain level (25-100%)
- determine desire frequency of dosing
- divide escalated dose by frequency
Opioid tolerant:
Analgesic effectiveness can be reassessed after __ hours
24
or when at steady state (3-5 half lives)
Opioid tolerant:
Can titrate PRN dosing up __ % in very sensitive pts
10
Opioid tolerant:
Can titrate PRN dosing up __ to __ % for mild to moderate uncontrolled pain
25, 50
Opioid tolerant:
Can titrate PRN dosing up __ to __
% for severe uncontrolled pain
75, 100
A reasonable opioid tapering regimen involves a __ % reduction per week/month
10
3 most common meds used in PCA pumps
morphine
hydromorphone
fentanyl
Which type of pain pump affects only the surgical site?
elastomeric reservoir ball (On-Q)
ropivacaine, bupivacaine, lidocaine
What type of pain control is used for trauma/fracture in the ED?
PRN IV pain meds
Patients on opioids will require a ___, even in acute setting.
bowel regimen
