| definition of pain | Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage |
| what are the 4 categories of pain | acute, nociceptive categorised under acute, chronic and neuropathic |
| what is chronic pain | prolonged, intensity varies, lasts >6mths, associated with depression, loss of work, fatigue, anger, frustration. Management is important |
| what is neuropathic pain | (pathophysiological) centrally generated from the central nervous system (phantom pain) or peripherally generated (neuropathies: diabetes, nerve entrapment) |
| what is acute pain | A protective mechanism
A response to internal or external stimuli
i.e. Acute abdominal pain or hot frying pan handle |
| what is nociceptive pain | Nociceptive pain (physiological)
The sensory response to noxious stimuli that implies damage or potential damage to somatic or visceral tissues
Somatic: Bone & soft tissue
Visceral: Organs found in GI tract & Pancreas: Can be caused by an obstruction |
| what are the 5 Phases of nociception | Transduction, Conduction Transmission, perception and modulation, |
| what is transduction | transduction is converting the noxious stimuli into electrical energy |
| what is conduction | where the electrical energy travels through the nerves |
| what is transmission | transmission is when the electrical signal reaches the dorsal root of the spine which take the message to the brain |
| what are the three catergories of noxius stimuli | MECHINICAL: Pressure, swelling, incision, tumour growth
THERMAL: Burns & scalds
CHEMICAL: Toxic substances |
| what is perception | perception is when the electrical signal reaches the brain and pain is felt, which triggers responses and emotions |
| what is modulation | Inhibitory mechanism involving multiple sites
Descending pathway
Spinal cord
Release of neurochemicals
endogenous opiods (endorphins/encaphalin)
serotonin
noradrenaline |
| what are the 5 dimensions of pain | sensory, cognitive, socio-cultural, behavioural and affective |
| what is the sensory dimension of pain mean | The recognition of pain
Consider sensory pain elements
Pattern
Area
Intensity
Nature |
| what is the affective dimension of pain mean | Refers to emotional responses
Anger, Fear, Depression,
Anxiety, Laughter |
| what is the cognitive dimension of pain mean | Cognitive
Refers to beliefs, attitudes, memories
Age, gender and education have also been found to influence pain beliefs and coping |
| what is the behavioural dimension of pain mean | Behavioural
Refers to observable actions to express or control pain
Facial expressions, Posture, change in daily activities |
| what is the sociocultural dimension of pain mean | Sociocultural
Encompasses
demographics, support systems, social roles and culture |
| assessment of pain | PQRSTU
provoking- does anything make it worse or better
quality - what the pain feels like
region - where is it? localised does it feel the same anywhere else?
severity - how much does it hurt? 1-10?
time - when did the pain begin
client understanding - what treatments have you tried? |
| what is the pain assessment for non verbal patients | FLACC
Face - facial expression
Legs - relaxed, tense or kicking
Activity - moves easily, tense, aching
Cry - no cry, whimpers , occasional complains, frequently complaining and cries
Consolability - relaxed, needs to be distracted, difficult to comfort |
| older patients how do you assess pain | using a number scale and asking if they feel the pain anywhere else |
