1 marilyn gripping sept. 18, 2010. 2 disclaimer the views and opinions i present today are entirely...
TRANSCRIPT
![Page 1: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/1.jpg)
1
Marilyn GrippingSept. 18, 2010
![Page 2: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/2.jpg)
2
DisclaimerThe views and opinions I present today
are entirely my own. They do not necessarily reflect the views of the Calgary Health Region, or either of Norquest or Bow Valley Colleges.
My views and opinions should not be construed as an official explanation or interpretation.
![Page 3: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/3.jpg)
3
Disclosure I have no relationship that could be perceived as placing me in a real or apparent conflict of interest in the context of this presentation.
![Page 4: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/4.jpg)
4
What is Pain? “An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.” (Jovey, page 9)
![Page 5: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/5.jpg)
5
“Whatever the person experiencing it says it is and exists whenever he says it does.” (Linton, 202)
![Page 6: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/6.jpg)
6
Factors Influencing Pain Experience
Pain ThresholdPain ToleranceAgePhysical ActivityNervous System Integrity
![Page 7: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/7.jpg)
7
Surgery/AnesthesiaCultureReligious BeliefsPast Experiences/AnxietySituational Factors
![Page 8: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/8.jpg)
8
Perception of PainAfferent pathways
NociceptorsCNS
Pain receptorsSpinal cordBrain
Efferent pathwaysDescending pathway
![Page 9: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/9.jpg)
9
Endorphins and EnkephalinsBody’s natural opioid-like
substancesBlock transmission of pain to spinal
cordIndividuals produce different
amounts
![Page 10: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/10.jpg)
10
Decrease EndorphinsProlonged stress
PainUse of opioids
Alcohol
![Page 11: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/11.jpg)
11
Increase EndorphinsBrief stress
PainLaughter,ExerciseAcupunctureTranscutaneous Electrical Nerve Stimulation
(TENS)Massive TraumaSexual Activity
![Page 12: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/12.jpg)
12
Gate-Control TheoryPain reflects both physical and psychosocial factors
![Page 13: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/13.jpg)
13
Gate-Control Theory
![Page 14: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/14.jpg)
14
Gate-Control Theory – con’t
![Page 15: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/15.jpg)
15
Gate-Control Theory – con’t
![Page 16: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/16.jpg)
16
Types of PainAcuteSubacuteChronicBaseline PainBreakthrough Pain
![Page 17: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/17.jpg)
17
Categories of PainNociceptive
SomaticVisceral
NeuropathicCNCP (Chronic Non-Cancer Pain)
![Page 18: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/18.jpg)
18
Pain SeverityPain ScalePain is rated on a scale of 0-10 where “0” is no pain and “10” is the worst pain imaginable or the worst pain the person has ever had.
![Page 19: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/19.jpg)
19
Statistics1/3 of all people suffering with chronic pain
are treated successfully with NSAIDsChronic pain in elderly is very common and is
often undertreatedRisk of addiction is usually less than the need
to control chronic pain
![Page 20: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/20.jpg)
20
The Treatment ContinuumMost efficient use of locally available
medical resourcesMore available, less expensive, less
invasive, fewer side effectsLess available, more expensive,
more invasive, more side effects
![Page 21: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/21.jpg)
21
Examples:PhysicalPsychologicalPharmacologicalInvasive Therapies
![Page 22: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/22.jpg)
22
Prescribing of pain medsDose to effectExceptions:
NSAIDSAntidepressantsAnticonvulsants
![Page 23: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/23.jpg)
23
Analgesic Ladder
![Page 24: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/24.jpg)
24
AdjuvantsDrugs primarily developed to treat other conditions
![Page 25: 1 Marilyn Gripping Sept. 18, 2010. 2 Disclaimer The views and opinions I present today are entirely my own. They do not necessarily reflect the views](https://reader030.vdocuments.net/reader030/viewer/2022032806/56649efb5503460f94c0df79/html5/thumbnails/25.jpg)
25
Bibliography Dhalla, Irfan A, et al. (2009). Prescribing of opioid analgesics and
related mortality before and after the introduction of long-acting oxycodone. CMAJ-JAMC, 181 (12), 891-896.
Fischer, Benedikt, Rehm, Jurgen (2009). Deaths related to the use of prescription opioids. CMAJ-JAMC, 181 (12), 881-882.
Jovey, Roman D. (Ed). (2008). Managing Pain – The Canadian Healthcare Professional’s Reference. (2008 Edition). City: Purdue Pharma.
Kozier, B., Erb. G., Berman, A., Snyder, S., Bouchal, D.S.R., Hirst, S., et al. (2010). Fundamentals of Canadian Nursing: Concepts, process and practice (2nd Canadian ed.) Toronto: Pearson Education Canada.
Linton, A. (2007). Introduction to medical-surgical nursing (4th ed.). Philadelphia, PA: Saunders.