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As defined by International Association for the Study of Pain: “An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage”
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“The most reliable indicator of the existence and intensity of acute pain” is the patient's self-report (Emerg Med Clin North Am 2005;23:393).
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- For nonverbal or cognitively impaired children, use behavioral and physiologic indicators or scales.
- Pain intensity and response to treatment must be continually monitored and reassessed regularly.
- Pain assessment should be individualized, taking into account age, race, gender, culture, emotions, development, expectations, and prior experiences.
- Pain prevention is better than treatment; anticipate procedure-related pain and prepare patient and parents.
- Poorly controlled pain can have short- and long-term physical and psychological consequences.
- Adequate pain prevention and control can have short- and long-term benefits.
- Unexpected intense pain, especially if associated with altered vital signs, should be evaluated for other possible diagnoses.
- World Health Organization Analgesic Ladder: Physical measures, nonopioid analgesics, oral opiates, and IV opiates may be used in a stepwise manner.
- Other adjuncts, including local anesthetics, anxiolytics, antidepressants, muscle relaxants, anticonvulsants, and cognitive/behavioral therapies should be used with analgesics for an integrated approach to pain management.
- The goal is to reduce pain to acceptable levels while considering the possible adverse reactions and side effects of each medication.
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Physiologic parameters: Tachycardia, vasoconstriction, diaphoresis, pupil dilatation, increased minute ventilation, hypertension
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