Assessment of Pain in the Critically Ill

Kwekkeboom, Kristine L.; Herr, Keela

doi:10.1016/s0899-5885(18)30048-0

Cited by 65 publications

(36 citation statements)

References 47 publications

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“…Patients' inability to selfreport pain is a marked barrier to effective assessment and management of pain. Because impaired communication is common among critically ill patients as a result of sedation, altered level of consciousness, and endotracheal intubation, 6 clinicians cannot use self-report tools and must rely on alternative methods to determine if a patient has pain. ventilation, and length of ICU stay.…”

Section: Study Design Participants and Settingmentioning

confidence: 99%

Behavioral Pain Assessment Tool for Critically Ill Adults Unable to Self-Report Pain

Rose¹,

Haslam²,

Dale³

et al. 2013

American Journal of Critical Care

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Section: Study Design Participants and Settingmentioning

confidence: 99%

Behavioral Pain Assessment Tool for Critically Ill Adults Unable to Self-Report Pain

Rose¹,

Haslam²,

Dale³

et al. 2013

American Journal of Critical Care

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“…The BPS focuses on behavioral observations only (facial expression, cry, and movements), whereas the NVPS includes behavioral and physiological indicators. Although the ICU nurses recognized that physiological indicators should not be used as the sole indicators of pain level, they thought that a combination of behavioral and physiological indicators of pain would be more comprehensive 7,8 than use of behavioral indicators alone. Additionally, they thought that use of the BPS might be confusing because the maximum score is 8 and that might be seen as lesser pain when compared with the maximum score of 10 used in other pain scales.…”

Section: Clinical Articlementioning

confidence: 99%

Further Validation of the Nonverbal Pain Scale in Intensive Care Patients

Kabes

Graves

Norris

2009

Critical Care Nurse

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“…Many medical conditions, critical illnesses and critical care procedures, such as intubation, suction, immobilization, repositioning, and invasive monitoring evoke pain (Stanik-Hutt 2003, Kwekkeboom & Herr 2001. Respiratory distress, hypoxemia, and mechanical ventilation, particularly the presence of endotracheal tubes and airway suctioning, may also induce anxiety, in addition to pain and discomfort (Tracy & Chlan 2011, Nelson et al 2004, Costa et al 2006, Pun & Dunn 2007.…”

Section: Introductionmentioning

confidence: 99%

Effects of Natural Sounds on Pain: A Randomized Controlled Trial with Patients Receiving Mechanical Ventilation Support

Saadatmand

Rejeh

Heravi‐Karimooi

et al. 2015

Pain Management Nursing

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Background: Non-pharmacological pain management in patients receiving mechanical ventilation support in critical care units is under-investigated. Natural sounds may help reduce the potentially harmful effects of anxiety and pain in hospitalized patients.Aims: This article examines the effect of pleasant, natural sounds on self-reported pain in patients receiving mechanical ventilation support.Design: A pragmatic parallel arm randomised controlled trial. Settings:A general adult ICU of a high turnover teaching hospital, Tehran, Iran. Participants/Subjects: Sixty patients receiving mechanical ventilation supportMethods: Between Oct 2011 and June 2012, we recruited sixty patients receiving mechanical ventilation support to intervention (n=30), and control arms (n=30) of a pragmatic parallel group randomized controlled trial. Participants in both arms wore headphones for 90 minutes. Those in the intervention arm heard pleasant natural sounds, while those in the control arm heard nothing.Outcome measures included the self-reported Visual Analog Scale (VAS) for pain at baseline, and 30, 60, 90 minutes into the intervention and 30 minutes after the intervention.Results: All those approached agreed to participate. The trial arms were similar at baseline. In the intervention arm, pain scores fell and were significantly lower than in the control arm at each time point (p < 0. 05). Conclusions:Administration of pleasant natural sounds via headphones is a simple, safe, nonpharmacologic nursing intervention that may be used to allay pain for up to 120 minutes in patients receiving mechanical ventilation support.Key words: mechanical ventilation, nurse, nursing, pain, randomised controlled trial, sounds. 2 BackgroundPain is the fifth vital sign. Its management is central to the care of critically ill patients, but is sometimes misunderstood and poorly executed by nurses (Aslan et al. 2003, Summer & Puntillo et al. 2001, Shannon & Bucknall 2003, Higgins et al. 2004, Gélinas et al. 2004, Gélinas et al. 2006. Pain is frequently a barrier to caring, haemodynamic stability and healing (Cullen et al. 2001).The need for mechanical ventilation, to maintain adequate oxygenation and protect the airway, is one of the principal reasons for admission to Intensive Care Units (ICUs). Many medical conditions, critical illnesses and critical care procedures, such as intubation, suction, immobilization, repositioning, and invasive monitoring evoke pain (Stanik-Hutt 2003, Kwekkeboom & Herr 2001. Respiratory distress, hypoxemia, and mechanical ventilation, particularly the presence of endotracheal tubes and airway suctioning, may also induce anxiety, in addition to pain and discomfort (Tracy & Chlan 2011, Nelson et al. 2004, Costa et al. 2006, Pun & Dunn 2007. Therefore, provision of adequate care to mechanically ventilated patients usually entails administration of opioids not only to decrease pain and discomfort, but also tominimize the anxiety, tachypnoea and hypertension associated with the unpleasant experiences of endotracheal...

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Assessment of Pain in the Critically Ill

Cited by 65 publications

References 47 publications

Behavioral Pain Assessment Tool for Critically Ill Adults Unable to Self-Report Pain

Behavioral Pain Assessment Tool for Critically Ill Adults Unable to Self-Report Pain

Further Validation of the Nonverbal Pain Scale in Intensive Care Patients

Effects of Natural Sounds on Pain: A Randomized Controlled Trial with Patients Receiving Mechanical Ventilation Support

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