Management of Acute Pain- 10

Question 1

What are observational changes associated with pain.

Answer 1

Sweating, increased breathing rate, hypertension
Grimacing, frowning
Pacing, rocking
Sighing, grunting, moaning
Aggression, altered sleep, crying, distress

Question 2

What is acute pain and what does it effect

Answer 2

Toothache, headache, leg fracture, post-surgical.
Duration of under 3 months.

Sympathy and Help
Short term inability to partake in things
Analgesia effective

Question 3

What is chronic/persistent pain and what does it effect

Answer 3

Osteoporosis-arthritis, Rheumatoid Arthritis, Neuropathy, Chronic lower back pain

Sympathy and help drying up
Financial Issues
Pain Meds less effective

Question 4

What is Nociceptive pain and what are some words used to describe it

Answer 4

It is pain that develops in response to a specific stimuli to the body, can be somatic or visceral.

Sharp, Aching, Throbbing

Question 5

What is Neuropathic pain and what are some words used to describe it.

Answer 5

Pain that comes from damage to the central or peripheral nervous systems.

Tingling, Shooting, Stabbing, Burning, Numb

Question 6

What are some specific assessment questions for pain?

Answer 6

Who?
Where is the pain?
How did it happen?
How would you describe the pain?
How long have you experienced the pain?

How would you rate it on a scale of 1-10
Persistent or does it come and go?

Question 7

Red flag symptoms for pain.

Answer 7

Bleeding
Pain radiating from the spine.
Dizzy
Recent head injury in the previous 3 months
Loss of physical function
Unexplained weight loss.
Visual Disturbance
Clinical Judgement.

Question 8

What are some non-pharmacological options for pain.

Answer 8

Important to continue with reduced/light activity, walking, physiotherapy, change of environment.

Question 8

Medications to treat mechanical nociceptive pain.

Answer 8

Paracetamol
Opioids- Codeine (no evidence of efficacy at 8/12)

Question 8

medications used to treat Inflammatory nociceptive pain

Answer 8

Ibuprofen
Diclofenac gels

Question 9

Medications used to treat Neuropathic pain

Answer 9

Amitriptyline
Gabapentin

Question 10

Counselling points for paracetamol

Answer 10

Weight based dosage
Maximum of 4g per day for adults
Every 4-6 hours and a maximum of 8 daily
Can be used in combination with ibuprofen- take each first tab together then space out 6 hours for paracetamol and 8 hours for ibuprofen.

CHECK THAT THEY ARE NOT TAKING ANY OTHER OTC THAT MIGHT CONTAIN PARACETAMOL ie cough/cold remedies.

Question 11

Counselling points for Ibuprofen

Answer 11

Wait 48 hours after injury to allow bodies natural response to kick in.
Taken every 6-8 hours AFTER FOOD.
Available in gels which can be used for soft tissue injury.

Question 12

Closing the assessment statements.

Answer 12

Benefits- be clear on the benefits and when they are likely to happen and what to do if not effective ie safety netting
Alternatives- Non pharm advice rest, hydration, physio
Risks- and how to manage/avoid/ how it would present
Nothing- what if the person does nothing? could be an option if pain is likely to pass.