Pain (Principles/meds/comfort Care)
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DescriptionUnpleasant sensory and emotional experience that may be secondary to actual or perceived damage to tissue, the somatosensory system, or a psychogenic dysfunction.
- It is an individual, subjective, multifactorial experience influenced by culture, medical history, beliefs, mood and ability to cope.
EpidemiologyIncidence and Prevalence Estimates
- Most common reason for seeking health care
- Up to 78% of visits to the emergency department.
- Pain is severe for 2/3rds of patients presenting with pain.
- Chronic pain is present in up to 35% of the population.
- Prevalence of neuropathic pain is 21.4% in emergency departments.
- Different components of pain can be combined in a same patient.
- Nociceptive pain:
- Stimulation of peripheral nerve fibers (nociceptors) that arises from actual or threatened damage to non-neural tissue.
- Visceral pain:
- Stimulation of visceral nociceptors
- Diffuse, difficult to locate, and often referred to a distant, usually superficial, structure.
- Sickening, deep, squeezing, dull.
- Deep somatic pain:
- Stimulation of nociceptors in ligaments, tendons, bones, blood vessels, fasciae, and muscles
- Dull, aching, poorly localized pain.
- Superficial pain:
- Stimulation of nociceptors in the skin or other superficial tissue.
- Sharp, well defined, and clearly located.
- Neuropathic pain:
- Exacerbation of normally nonpainful stimuli (allodynia).
- Paroxysmal episodes likened to electric shocks.
- Continuous sensations include burning or coldness, “pins and needles” sensations, numbness and itching.
- Psychogenic pain:
- Pain caused, increased or prolonged by mental, emotional, or behavioral factors.