Management of Pain and Distress in the Adult ICU patient
Year: 2008
Type: dissertation
Abstract: The literature presents vast amounts of scientific evidence as to the significance of pain in the process\nof severe illness, yet evidence on the effectiveness of pain assessment and pain management for the\nadult critically ill patient is scarce. In critically ill adult patients the process of clinical decision making\nfor pain interventions remains very complex.\nThe Critically Ill Assessment (CIA) scale is introduced, a new pain-distress observational tool for\ncritically ill adult patients, either ventilated or non-ventilated. The CIA scale proves to be a reliable and\nvalid assessment tool for uncomfortable adult critically ill patients. The complexity of adherence to\nclinical guidelines is discussed. Issues of implementation need to be taken seriously, the introduction\nof a new health care professional: the implementologist, can be useful.\nThe development and implementation of a new pain-distress treatment algorithm, based on\nassessment with the C.I.A., is described. Attitude versus behaviour towards a new clinical strategy\nwas investigated. Attitude by the results of a questionnaire, behaviour as compliance to the algorithm.\nThe correlation between clinical sedation scales and the bispectral index (BIS) was investigated and\nwas found modest. The BIS has failed to demonstrate consistent reproducibility as a monitor of\nsedation in heterogeneous populations of ICU patients.\nThe challenges to pain management are described and taken to a broader perspective in making it part\nof the multimodality approach, as well as indicating it as an essential component of quality care. High\nquality pain management should be a goal for every patient. The key is in the education!
Author: F J Schoonderbeek
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1526751275