ICU pain and delirium Flashcards
what are the 3 quality of evidence ratings for guideline recommendations
A = High B = moderate C = observational study only (weak)
what percent of patients remember pain more than any other event in the ICU
82%
untreated pain can lead to what
chronic pain
PTSD
lower health related quality of life
what are 4 ways pain is assessed in ICU
- cisual analogue scale
- numeric rating scale
- subjective measures
- objective measures
what are the objective measures for pain
- heart rate
- bp
- respiratory rate
what are the subjective measures for pain
- facial grimacing
- sweating
- head movements
- posturing
opdiods stimulate what receptors
mu, kappa and delta receptors (produce both analgesia and sedation)
what are the most commonly used drugs for pain in the ICU
- fentanyl
- morphine
- hydromorphone
what is usually used for pain in renally impaired patients
morphine (metabolized hepatically)
what is an opioid adverse reaction especially pertinent with morphine
hypotension
what are the characteristics of an ideal sedative
- rapid onset
- easy titration
- lack of accumulation
- no active metabolites
- rapid awakening
- inexpensive
what are the consequences of negletincg anxiety
- ventilator dyssynchrony
- agitation
- increased O2 consumption
- removal of lines or catheters
what are the goals of sedation
- analgesia
- anxiety
- amnesia
- paralysis
what is the MOA of benzodiazepines
enhances inhibitory effect of GABA receptors
what beneficial effects do Benzo’s have to patients in the ICU? what effect do they not have?
potent anxiolytic and amnestic effects
No analgesic effects
