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Assessment of Acute Pain

Pain can be described as:

"An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage"
International Association for the Study of Pain 1979

Acute pain is described as a pain of recent onset and progression, but of a limited duration. If not treated effectively acute pain can progress to chronic (long term) pain conditions.

For pain management to be effective it is essential that careful assessment and regular review of pain is undertaken. Pain is a subjective symptom, and as such, an individual’s own description of their pain or ‘self-report’ is the most accurate measure and should be used whenever possible. Pain assessment involves both an initial, detailed evaluation of each type of pain, and then regular reassessment of severity of pain and the response to treatment.

The pain assessment tool used in clinical practice is based on the patient’s own perception of their pain and its severity. The tool is on the Observation, Early Warning Score (EWS) and Pain Management Chart.

Pain Assessment Tool

The goals of pain assessment are to:

·        Define the severity of pain

·        Assist in the selection of appropriate analgesia

·        Evaluate the response to treatment

Pain has complex mechanisms and the severity of pain will depend on the extent, degree and site of tissue injury or damage. The patients’ perception of pain is multi-factorial and includes the physical, psychological, social factors as well as previous pain experiences.

Many processes and pathways are involved and because of this complexity it is usual to use a number of analgesics or pain relieving strategies together, each working on different components of the pain response in order to achieve a synergistic or complementary effect: a technique often known as multi-modal analgesia. The World Health Organisation Analgesic Ladder a universally recognised tool to aid effective analgesic prescribing.

Pain medication is often prescribed on an ‘as required’ or PRN basis for convenience but often such treatments will need to be given regularly when significant pain is expected e.g. after surgery.

Pain, and the response to treatment, must always be assessed using the Trust pain assessment tool and documented as a ‘Pain Score’ on the Pain Management Chart. Whenever possible, pain should be anticipated and treatment given prophylactically.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Pain Service Website, Gloucestershire Hospitals NHS Foundation Trust
Webmaster Dr J G de Courcy, Consultant in Pain Medicine and Anaesthesia
email: pain.webmaster[at]glos.nhs.uk

Page updated 19/02/2016