plastic surgery team utilize all six doses of Oramorph and make provision for on-the-clock pain assessments. Medications The plastic surgery team, upon recognizing the need for adequate pain therapy as advised, developed a therapy plan primarily including a procedural analgesic agent and a procedural anxiolytic agent. ● Opiates: Fentanyl (administered intranasal) 1.5–2 mcg/kg. ● Nitrous Oxide: Entonox (inhaled) titrated to effect. ● NMDA Antagonist: IV Ketamine 0.1–0.3 mg/kg. ● Benzodiazepines: PO Temazepam 10 mg. ● a2-agonist: Dexmedetomidine Buccal 1–4 mcg/kg (max 100mcg). Edwin’s case effectively described how procedural pain management in young adults can be executed with a direct emphasis on risk factor assessment and collaborative interaction between medical teams. However, in many cases, the combination of both pharmacological and nonpharmacological approaches to pain management is strongly advised. Self-Assessment Quiz Question #21 In the initial medical work up plan for Edwin, which of the following diagnosis was made? a. Anxiety. b. Acute pain. c. Procedural pain. d. Hypertension in a young adult. Self-Assessment Quiz Question #22 The use of opiates in the second therapy plans exposed Edwin to which of the following side effects? a. Respiratory depression. b. Decreased appetite stimulation. c. Hypotension. d. Scurvy.
Self-Assessment Quiz Question #23 Which of the following was incorporated as an anxiolytic agent in the second therapy plan? a. Ketamine. b. Temazepam. c. Fentanyl. d. Oramorph. Self-Assessment Quiz Question #24 Which of the following was also assessed by the pain team in Edwin’s case? a. Respiratory depression. b. Parental neglect. c. Pain-related anxiety. d. Burns infection. Self-Assessment Quiz Question #25 Which of the following pain assessment methods was deployed in this case study? a. Smiley face survey. b. American Pain Society Sensation Scale. c. The Pain Numerical Scale. d. The South African Pain Classification Scale.
HOW PAIN IMPACTS THE GLOBAL ECONOMY
Over the last decade, a few publications exploring the global economic burden of pain have been published. These submissions assess the cost and burden of chronic noncancer pain, persistent or episodic nociceptive pain of a duration or intensity that adversely affects the function or well-being of the patient. According to a 2008 Medical Expenditure Panel Survey (MEPS), about 100 million adults in the United States were affected by chronic pain, including joint pain or arthritis. For those who suffer pain, it limits their functional status and Costs to benefit agencies The two health conditions most clearly associated with disability benefits are musculoskeletal disorders (particularly nonspecific lower back pain and general chronic pain syndromes) and mental health it is however difficult to ascertain how these conditions have impacted benefit agencies in every country of the world. For the most part, only a few studies are exploring this subject in different parts of the world. However, in the UK, complaints about these two health conditions comprise more Cost to health services Estimates of the costs to health services resulting from pain and its management generally constitute a relatively small proportion of the total cost burden, although differences in methodologies and patient management and treatment approaches make cross- country comparisons difficult. However, the total cost of pain to the health services seems to be influenced by the quality of care received by patients. Preliminary investigations in this regard submit that patients with chronic pain who are managed poorly will bounce around the healthcare system, becoming increasingly exasperated and consuming considerable resources. Country-
adversely impacts their quality of life. Pain negatively affects a nation by sometimes requiring medical treatment. Pain also complicates medical care for other ailments, and it hinders one’s ability to work and function in society. To properly understand how untreated pain affects the global economy, this section of the course is structured into different subheadings that directly weigh the impact of pain on economies, health services, and benefits agencies. than 50% of sick certifications. Musculoskeletal complaints, predominantly mild to moderate in severity, and often with no clear or consistent underlying pathology, account for around 20% of benefit recipients in the UK and therefore account for a significant proportion of incapacity for work. Given that the annual economic costs associated with sickness absence and worklessness amount to over £100 billion, the impact of pain and associated conditions remains a significant contributory factor. specific analyses also seem to agree with this observation. For instance, a 2007 analysis of a Canadian database demonstrated that from the perspective of the health ministry, costs of health care resources were significantly higher in patients with painful neuropathic disorders than those patients without such conditions but matched for age and sex (Cdn$4,163 as opposed to Cdn$1,846— £2,071 as opposed to £918). In the same vein, an Australian study has also shown that chronic pain was associated with increased hospitalization and primary
Book Code: PYFL4024
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