Quick Pain question

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Hi everyone, can I know how you can tell if a person is having pain. Can high or low blood pressure tell? Or hyperventilation? Also, if a person is feeling dizzy, how would you take the blood pressure? Is it sitting, standing, and lying? Thanksssssssssssssssssssss...

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Specializes in ED.

It's hard to tell, especially if it is chronic pain. Sometimes the person might be tachy or slightly hypertensive. The most accurate clinical presentation is probably diaphoresis. Technically, a patient is having pain if they say they are having pain. I don't have much faith in the "pain scale" thing, but it's the best we have. I have my own way of telling how much pain a person is in. If you are screaming in pain and I stick you with an IV needle and you don't change your demeanor, then I know you are in pain. If you wail like you're being disemboweled, then I don't believe you so much. There is no way that IV prick hurts so bad that it would make you scream louder if you were already in so much pain.

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

I must disagree. The best way to find out about pain is taking a pain management course. There are many, many differences in taking care of patients who are opiate-naive versus those who are not opiate-naive (chronic pain). There are many circumstances that require different interventions and this is forum is too small to go through all of these explanations.

I hope it helps.

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
It's hard to tell, especially if it is chronic pain. Sometimes the person might be tachy or slightly hypertensive. The most accurate clinical presentation is probably diaphoresis. Technically, a patient is having pain if they say they are having pain. I don't have much faith in the "pain scale" thing, but it's the best we have. I have my own way of telling how much pain a person is in. If you are screaming in pain and I stick you with an IV needle and you don't change your demeanor, then I know you are in pain. If you wail like you're being disemboweled, then I don't believe you so much. There is no way that IV prick hurts so bad that it would make you scream louder if you were already in so much pain.

I think it would be wise to add that this experience is because of your exposure in the ER?

I do not think this applies to ALL areas, as post-surgical pain is treated very differently related to the anesthestics used, length, type of surgery etc.,--it is treated very aggressively--even if patient is still under effects of anesthesia AND sleepy. I've had patients lay there like they are asleep whisper in my ear that their pain is a "10". I believe them.

Pain is what the patient says it is.

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Specializes in LTC, Memory loss, PDN.

If a patient complains of dizziness (when getting up), just do a tilt.

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Specializes in PICU, NICU, L&D, Public Health, Hospice.

"I think it would be wise to add that this experience is because of your exposure in the ER?

I do not think this applies to ALL areas, as post-surgical pain is treated very differently related to the anesthestics used, length, type of surgery etc.,--it is treated very aggressively--even if patient is still under effects of anesthesia AND sleepy. I've had patients lay there like they are asleep whisper in my ear that their pain is a "10". I believe them.

Pain is what the patient says it is. "

Thank you JoPACURN!!

Too few professionals realize that "sleep" is a favorite method of coping with pain. How many nurses have taken care of people who are in excrutiating pain in the morning because the night shift nurse peeked into the room and saw the pt lying with their eyes closed and presumed they were comfortable and sleeping? I have a friend who started in the ER...she had a very specific idea about pain. Then she switched to hospice...developed a very different idea about pain. Now she is doing both and she believes that her hospice experience has exponentially improved her ability to deal with the frequent flyers who visit for pain issues.

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Specializes in Acute Care Cardiac, Education, Prof Practice.

Too few professionals realize that "sleep" is a favorite method of coping with pain. How many nurses have taken care of people who are in excrutiating pain in the morning because the night shift nurse peeked into the room and saw the pt lying with their eyes closed and presumed they were comfortable and sleeping? I have a friend who started in the ER...she had a very specific idea about pain. Then she switched to hospice...developed a very different idea about pain. Now she is doing both and she believes that her hospice experience has exponentially improved her ability to deal with the frequent flyers who visit for pain issues.

I understand your point, but it still does not mean I am going to go in and give a person pain medications. I am not a fan of Narcan, nor am I of poking a patient every two hours saying "hey are you in pain?"

I take a lot of time with my patients to work out a regiment which includes a schedule on the board that I change each time I give the pain med, for each pain med, if someone is on several. Then I tell my patient "If you wake up you will know exactly when we can do another dose." I also check in with all my patients in the morning, around 0600, and see if they are in need of anything before I leave.

As far as the OP and their question: I watch for grimacing, guarding, tension, increased HR or BP and of course verbalization combined with the overall non-verbal picture I am getting from them.

Tait

ALSO considering pain is what the patient says it is we can not always be held responsible for what is communicated to us.

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