PAINAD Lake Health System Emergency Services中文版PAINAD湖卫生系统急救服务.pptVIP

PAINAD ASSESSING PAIN IN PATIENTS WITH ADVANCED DEMENTIA OBJECTIVES Discuss the definition of pain Review the various ways pain is assessed at LHS Review the five components of pain Explain the use of the PAINAD Scale Apply the concept of PAINAD to situations. HISTORICAL FACTS Self report of pain most reliable measure of pain intensity Many patients unable to rate their pain using the Wong-Baker rating scale These include: infants, young children, pts with advanced dementia, sedated or intubated patients Pain Assessment Tools at LHS Wong-Baker Scale (1-10 scale) – used for responsive adult patients FLACC Scale developed to measure pain in infants and young children FLACC used at LHS for other types of non-verbal patients Research indicates FLACC is not useful in assessing pain of the cognitively impaired elderly population PAIN Pain can be defined in two ways. Clinically-based Scientifically-based PAIN Clinically-based Pain: Whatever the experiencing person says it is, existing wherever the person says it does (McCaffery, 1997) Scientifically-based Pain “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage” (Mersey, 1994)  These components are interrelated and connected to the understanding of pain and pain management. Pain as a Multidimensional Phenomenon As a phenomenon pain is multidimensional and consists of five components: affective behavioral cognitive sensory physiological. Factors that are Influenced by the Perception of Pain Literature Review Literature on use of FLACC scale in the adult is negligible. FLACC scale developed to measure pain in infants and children who could not report pain. Ten pain assessment tools evaluated in nonverbal older adults with dementia. FLACC scale scored the lowest overall. Reliability and Validity of FLACC FLACC scale appropriate for infants and young children V