Seminars in respiratory and critical care medicine
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Semin Respir Crit Care Med · Apr 2013
ReviewA validated approach to evaluating psychometric properties of pain assessment tools for use in nonverbal critically ill adults.
A valid pain assessment is the foundation of adequate pain management. Pain assessment can be challenging, especially in adult intensive care unit (ICU) patients who are unable to self-report. In such situations, relying on observational assessment tools is an alternative strategy. ⋯ Each pain assessment tool was scored independently by two reviewers. Of the eight behavioral pain scales developed for use in adult ICU patients, the Behavioral Pain Scale (BPS) and the Critical-Care Pain Observation Tool (CPOT) are considered to be the most valid and reliable for this purpose, according to the available evidence. Behavioral pain scales may be viable alternatives to assessing pain in ICU patients who are unable to self-report, but only valid, reliable, and feasible scales should be used for this purpose.
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Semin Respir Crit Care Med · Apr 2013
ReviewEvaluation and treatment of pain in critically ill adults.
Pain is experienced by the overwhelming majority of patients during their intensive care unit stay, but it remains an underappreciated problem. To effectively treat pain, it must be detected and quantified using a validated assessment tool. ⋯ This review covers practices and techniques specific to addressing and treating pain in the adult intensive care environment. Traditional pharmacological approaches including opiate and nonopiate medications are reviewed, as are regional anesthetic techniques and nonpharmacological approaches used for controlling pain.