pain and discomfort
TRANSCRIPT
PAIN AND DISCOMFORT
WHAT IS PAIN?
• Unpleasant sensory and emotional experience associated with actual or potential tissue damage
• Pain is a protective mechanism
• Subjective
TYPES OF PAIN
• FAST AND SLOW PAIN
• ACUTE PAIN
• CHRONIC PAIN
• CHRONIC RECURRENT PAIN
SYMPTOMS OF PAIN
THEORIES OF PAIN
DESCARTES VIEW
• Rene’ Descartes
• Cartesian Theory of pain
• French Philosopher that first proposed that pain was a disturbance that passed down along nerve fibers until the disturbance reached the brain.
DESCARTES VIEW
INTENSIVE THEORY
• Whilliam Erb(1874)
• Also called as Intensity Theory
• Pain = stimulas intensity + central summation
• Dorsal horn cells
Specificity Thory
• Von Frey,1895
• First modern theory
• Pain centre in brain
• Separate sensory system for pain
• Free nerve endings are pain receptors
Pattern Theory
• JP Nafe, 1929
• Specific and particular pattern of nerve firing give pain sensation
• Touch receptors also sense pain
• Patterns occur with intense stimulation
The fourth theory of pain
• Hardy, Wolff, and Goodell, 1940s
• Pain has two components
– Perception
– Reaction
Central summation theory
• Livingstone,1943
• Intense stimulation from tissue damage pools within spinal cord
• Prolonged abnormal activity in spinal cord projects to brain for pain perception
Gate control theoy
• Melzack ad Wall, 1965
• There exist a gate system within spinal cord
• Inhibit = gate closed
• Allow = gate open
• T cells in substantia gelatinosa
Factors influencing gate control
• Amount of activity in pain fibers
• Amount of activity in other peripheral fibers
• Messages that descend from barin
Bio psycho social model of pain
PAIN ASSESSMENT
HOW WE MEASURE PEOPLE’S PAIN
THREE WAYS
• Self report
• Behavioural
• Physiological
Tools are assisted
FLACC
• Face
• Legs
• Activity
• Cry
• Consolabilty
• (used for neonatal babies)
Wong Baker faces pain scale
Uses self report of patient
Visual analogue scale
Physiological indicators
• Increased heart rate
• Increased respiratory rate
• Increased blood pressure
• Decreased oxygen saturation rate
MANAGING AND CONTROLLING
CLINICAL PAIN
Pharmacological control
• Nonopioid analgesics
• Nonnarcotic drugs
Surgical control
Repairing source or altering nervous system
Sensory Control
counterirritation
Biofeedback
Most common techniques
• Transcendental
• Mindfulness
Hypnosis
ACCUPUNTURE