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https://www.readbyqxmd.com/read/30515466/using-the-model-for-improvement-to-implement-the-critical-care-pain-observation-tool-in-an-adult-intensive-care-unit
#1
Mairi Mascarenhas, Michelle Beattie, Michelle Roxburgh, John MacKintosh, Noreen Clarke, Devjit Srivastava
Managing pain is challenging in the intensive care unit (ICU) as often patients are unable to self-report due to the effects of sedation required for mechanical ventilation. Minimal sedative use and the utilisation of analgesia-first approaches are advocated as best practice to reduce unwanted effects of oversedation and poorly managed pain. Despite evidence-based recommendations, behavioural pain assessment tools are not readily implemented in many critical care units. A local telephone audit conducted in April 2017 found that only 30% of Scottish ICUs are using these validated pain instruments...
2018: BMJ open quality
https://www.readbyqxmd.com/read/30439315/-comparison-of-two-schemes-of-daily-arousal-and-comfort-analgesia-and-sedation-in-patients-on-mechanical-ventilation-in-intensive-care-unit
#2
Kun Guo, Hongying Zhang, Siping Peng
OBJECTIVE: To explore the efficacy of comfort analgesia and sedation in patients with mechanical ventilation in intensive care unit (ICU). METHODS: Eighty patients with mechanical ventilation admitted to ICU of Pingxiang People's Hospital from June 2017 to May 2018 were enrolled, and they were randomly divided into control group and observation group by random number table method, with 40 patients in each group. The control group was given a daily analgesic and sedation regimen with critical-care pain observation tool (CPOT) 0-3 and Richmond agitation-sedation scale (RASS) maintained at -3 to -4...
October 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/30314837/implementation-of-the-critical-care-pain-observation-tool-increases-the-frequency-of-pain-assessment-for-noncommunicative-icu-patients
#3
Margaret Louise Phillips, Vijo Kuruvilla, Michael Bailey
BACKGROUND: Pain is a common stressor for ICU patients, necessitating routine assessment. For patients who are unable to communicate, self-report tools are unsuitable, and the use of an observational tool is required to assess pain appropriately. The Critical Care Pain Observation Tool (CPOT) is the most reliable tool currently available to assess pain in these patients. We investigated whether the implementation of the CPOT in one Australian ICU could increase frequency of appropriate pain assessments, and if this would affect the administration of analgesia and sedation...
October 9, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/30286403/validation-of-the-critical-care-pain-observation-tool-cpot-for-the-detection-of-oral-pharyngeal-pain-in-critically-ill-adults
#4
Craig M Dale, Virginia Prendergast, Céline Gélinas, Louise Rose
No abstract text is available yet for this article.
September 25, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30216182/electrodermal-activity-monitoring-during-painful-stimulation-in-sedated-adult-intensive-care-unit-patients-a-pilot-study
#5
Theodoros Aslanidis, Vasilios Grosomanidis, Konstantinos Karakoulas, Athanasios Chatzisotiriou
Introduction-Aim: Newer methods, such as infrared digital pupillometry and electrodermal activity (EDA) measurement have been suggested as good alternatives for analgesia monitoring in critically ill patients. This study analyzed EDA changes due to pain stimulus in sedated adult critical care patients Methods: Skin conductance variability, selected hemodynamic and respiratory parameters, Bispectral index (BIS) and ambient noise level, were monitored during 4 hour routine daytime in an adult ICU. 4h-Measurements were divided into 2 groups, based upon the sedation level of the patients: Group A - Ramsay Sedation Score 2-4 and Group B - Ramsay Sedation Score of 5-6...
2018: Acta Medica (Hradec Králové)
https://www.readbyqxmd.com/read/30100835/comparison-between-critical-care-pain-observation-tool-and-physiologic-indicators-for-pain-assessment-in-the-critically-ill-mechanically-ventilated-adult-patients
#6
Puneet Khanna, Ravinder Kumar Pandey, Chandralekha Chandralekha, Ankur Sharma, Neha Pangasa
Background and Objectives: Pain assessment of nonverbal, critically ill patients continues to present a challenge in Intensive Care Unit (ICU). The Critical-Care Pain Observation Tool (CPOT) rates critically ill patients' pain based on clinical observation. In the present study, the accuracy of CPOT was compared with physiological indicators of pain in mechanically ventilated, critically ill patients. Methods: This quantitative prospective observational study was conducted to assess pain in the critically ill, mechanically ventilated patients in comparison to physiologic indicators such as blood pressure and heart rate...
July 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/30036691/transcutaneous-electrical-nerve-stimulation-at-the-acupuncture-points-on-relieve-pain-of-patients-under-mechanical-ventilation-a-randomized-controlled-study
#7
Javad AminiSaman, Saeed Mohammadi, HasanAli Karimpour, Behzad Hemmatpour, Hengameh Sharifi, Rasool Kawyannejad
BACKGROUND AND OBJECTIVE: Electrical stimulation and acupuncture points as non-pharmacological methods, have been the focus of pain reduction in different patients. This study is aimed at determining the effects of transcutaneous electrical nerve stimulation (TENS) on the acupuncture points of pain in patients under mechanical ventilators. MATERIALS AND METHODS: This randomized, double blind clinical trial study was conducted on 50 patients undergoing mechanical ventilation in intensive care units of ImamReza hospital in Kermanshah, Iran in 2017...
July 20, 2018: Journal of Acupuncture and Meridian Studies
https://www.readbyqxmd.com/read/30009967/validation-of-two-pain-assessment-tools-using-a-standardized-nociceptive-stimulation-in-critically-ill-adults
#8
Cristini Klein, Wolnei Caumo, Céline Gélinas, Valéria Patines, Tatiana Pilger, Alexandra Lopes, Fabiane Neiva Backes, Débora Feijó Villas-Boas, Silvia Regina Rios Vieira
CONTEXT: The Behavioral Pain Scale (BPS) or the Critical-Care Pain Observation Tool (CPOT) are recommended in practice guidelines for pain assessment in critically ill adults unable to self-report. However, their use in another language requires cultural adaptation and validation testing. OBJECTIVES: Cross-cultural adaptation of the CPOT and BPS English versions into Brazilian Portuguese, and their validation by comparing behavioral scores during rest, standardized nociceptive stimulation by pressure algometry (SNSPA), and turning were completed...
October 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/30002708/validation-of-the-polish-version-of-the-critical-care-pain-observation-tool-cpot-to-assess-pain-intensity-in-adult-intubated-intensive-care-unit-patients-the-pol-cpot-study
#9
Katarzyna Kotfis, Małgorzata Zegan-Barańska, Marta Strzelbicka, Krzysztof Safranow, Maciej Żukowski, E Wesley Ely
Introduction: Pain in the critically ill affects nearly 50% of patients. In patients unable to self-report pain, behavioural scales are used. The aim of this study was to validate the Polish version of the Critical Care Pain Observation Tool (CPOT). Material and methods: The prospective observational cohort study included patients observed during non-nociceptive and nociceptive procedures, at rest, during the intervention, and 15 min after each intervention. Assessments included self-report by patients and CPOT assessment carried out by two blinded observers...
June 2018: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29953207/intracellular-delivery-via-noncharged-sequence-defined-cell-penetrating-oligomers
#10
Ngoc N Phan, Connie Li, Christopher A Alabi
Intracellular drug delivery systems are often limited by their poor serum stability and delivery efficiency. Cell-penetrating peptides (CPPs), particularly those derived from basic protein subunits, have been studied extensively in this regard and used for the delivery of a variety of cargoes in vitro. Although promising, traditional cationic CPPs have some drawbacks that hinder their therapeutic application such as rapid proteolytic degradation and undesired interactions with the biological milieu. To overcome these limitations, this article details the discovery of a new class of noncharged cell-penetrating oligoTEAs (CPOTs) that undergo extensive and rapid cellular entry across different cell lines with low cytotoxicity...
August 15, 2018: Bioconjugate Chemistry
https://www.readbyqxmd.com/read/29882581/icu-delirium-a-diagnostic-and-therapeutic-challenge-in-the-intensive-care-unit
#11
Katarzyna Kotfis, Annachiara Marra, Eugene Wesley Ely
ICU delirium is a common medical problem occurring in patients admitted to the intensive care units (ICUs). Studies have shown that ICU delirium is associated with increased mortality, prolonged hospitalization, prolonged mechanical ventilation, costs and the occurrence of cognitive disoders after discharge from ICU. The tools available for ICU delirium screening and diagnosis are validated tests available for all members if the medical team (physicians, nurses, physiotherapists). Their use for routine patient assessment is recommended by international medical and scientific societies...
2018: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29851854/use-of-the-critical-care-pain-observation-tool-and-the-bispectral-index-for-the-detection-of-pain-in-brain-injured-patients-undergoing-mechanical-ventilation-a-strobe-compliant-observational-study
#12
Kai Shan, Wei Cao, Yuan Yuan, Jing-Jing Hao, Xiu-Mei Sun, Xuan He, Gui-Yun Li, Yu-Mei Wang, Jian-Xin Zhou
The assessment of pain in patients with brain injury is challenging due to impaired ability to communicate. We aimed to test the reliability and validity of the critical-care pain observation tool (CPOT) and the bispectral index (BIS) for pain detection in critically brain-injured patients.This prospective observational study was conducted in a neurosurgical intensive care unit in a University-Affiliated Hospital. Adult brain-injured patients undergoing mechanical ventilation were enrolled. Nociceptive (endotracheal suctioning) and non-nociceptive (gentle touching) procedures were performed in a random crossover fashion...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29794299/reliability-of-three-linguistically-and-culturally-validated-pain-assessment-tools-for-sedated-icu-patients-by-icu-nurses-in-finland
#13
Sanna-Mari Pudas-Tähkä, Sanna Salanterä
BACKGROUND AND AIMS: Pain assessment in intensive care is challenging, especially when the patients are sedated. Sedated patients who cannot communicate verbally are at risk of suffering from pain that remains unnoticed without careful pain assessment. Some tools have been developed for use with sedated patients. The Behavioral Pain Scale (BPS), the Critical-Care Pain Observation Tool (CPOT) and the Nonverbal Adult Pain Assessment Scale (NVPS) have shown promising psychometric qualities...
April 25, 2018: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29764554/-efficacy-and-safety-of-nalbuphine-on-analgesia-of-patients-in-intensive-care-unit
#14
Shaohua Liu, Youdong Wan, Yonggang Luo, Li Wan, Wenjing Yun, Haixu Wang, Zhenhua Wang, Xiaoguang Duan, Ruifang Zhang, Yingying Zhao, Hongwei Cui, Tongwen Sun
OBJECTIVE: To analyze the efficacy and safety of nalbuphine in patients with sedative analgesia in intensive care unit (ICU). METHODS: A prospective observation was conducted. The adult patients with mild and moderate analgesia in general ICU of the First Affiliated Hospital of Zhengzhou University from January to November in 2017 were enrolled, and they were divided into nalbuphine group and sufentanil group in proper order. The nabobrown group was given 40 mg nabobrown, the sufentanil group was given 0...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29448873/comparison-of-self-reported-and-behavioral-pain-assessment-tools-in-critically-ill-patients
#15
Rima H Bouajram, Christian M Sebat, Dawn Love, Erin L Louie, Machelle D Wilson, Jeremiah J Duby
BACKGROUND: Self-reported and behavioral pain assessment scales are often used interchangeably in critically ill patients due to fluctuations in mental status. The correlation between scales is not well elucidated. The purpose of this study was to describe the correlation between self-reported and behavioral pain scores in critically ill patients. METHODS: Pain was assessed using behavioral and self-reported pain assessment tools. Behavioral pain tools included Critical Care Pain Observation Tool (CPOT) and Behavioral Pain Scale (BPS)...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29406365/acute-pain-assessment-in-sedated-patients-in-the-postanesthesia-care-unit
#16
Sherily Pereira-Morales, Carmen Mabel Arroyo-Novoa, Annette Wysocki, Lucille Sanzero Eller
CONTEXT: Acute postoperative pain remains inadequately assessed and managed. A valid instrument that assesses acute pain in sedated postanesthesia care unit (PACU) patients is needed. OBJECTIVES: Two behavioral pain assessment instruments, the NonVerbal Pain Scale Revised (NVPS-R) and Critical-care Pain Observation Tool (CPOT), were used to determine whether these instruments adequately assess acute pain in the PACU. METHODS: A crossover study design was used...
August 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29189705/validation-of-the-italian-version-of-the-critical-pain-observation-tool-in-brain-injured-critically-ill-adults
#17
Francesco Sulla, Nilson De Souza Ramos, Noemi Terzi, Tania Trenta, Mariella Uneddu, Melanny Alessandra Zaldivar Cruces, Leopoldo Sarli
BACKGROUND AND AIM: Pain in intensive care units (ICUs) is a frequent and often undermanaged problem. Brain-injured patients are often unable to reliably self-report their pain, calling forth the need to use behavioural scales such as the Critical-Care Pain Observation Tool (CPOT). This study aimed to test the reliability and validity of the Italian CPOT use with brain-injured ICU adults. METHOD: A sample of 50 adults critical care patients was included. Each patient was assessed by two independent observers at three predefined times - at rest; during mobilization for hygiene; 20 minutes later - using the CPOT, PAINAD, and NRS...
November 30, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29136716/-the-impact-of-goal-directed-analgesia-on-mechanical-ventilated-patients-s-outcomes-in-intensive-care-unit-a-clinical-observational-study
#18
Q D Li, X Y Wan, Y L Zhang, S W Li, L L Han, W W Li, H Y Shi
To investigate the impact of goal directed analgesia on the outcome of patients with mechanical ventilation in intensive care unit.A total of 126 patients who needed mechanical ventilation were recruited.With a method of before and after paired comparison, they were divided into two group: (1) analgesia with empirical administration or control group; (2) goal directed analgesia based on critical-care pain observation tool (CPOT). Compared with the control group, after goal directed analgesia was applied, the consumption of midazolam significantly dropped from (368...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28944633/-process-for-implementing-a-pain-assessment-scale-for-patients-with-brain-injuries-description-of-a-project-methodology-based-on-the-integrated-model-of-consultation
#19
Veronique de Goumoens, Francois Decaillet, Amelia Didier, Chantal Montreuil, Karin Diserens, Anne-Sylvie Ramelet
Background : in a neurosurgery unit, nurses selected the Critical Pain Observation Tool (CPOT) based on evidence to assess pain in brain-injured patients. However, months after implementation, nursing managers have observed an underutilization.Objectives : support a care team to overcome the pitfalls encountered during the implementation of the CPOT scale for brain-injured patients in neurosurgery unit.Methods : the Lescarbeau, Payette and St-Arnaud's Integrated Model of Consultation was selected. In addition to a scientific literature review, self-administered questionnaire and three interview guides were developed to gather the views of caregivers...
March 2017: Recherche en Soins Infirmiers
https://www.readbyqxmd.com/read/28936968/-progress-of-pain-assessment-and-analgesia-strategy-for-mechanical-ventilation-patients
#20
Qingdong Li, Xianyao Wan
Standardized pain assessment is a precondition of appropriate analgesia for mechanical ventilation patients. However, routine pain assessment rates remain very low in intensive care unit (ICU). Behavioral pain scale (BPS) and critical-care pain observation tool (CPOT) can be used to assess pain in mechanical ventilation patients who are unable to report pain by themselves. No matter what strategy we taken, analgesia-first sedation should be used in priority. Meanwhile, patient-centered and goal-directed sedation strategy should be adopted based on the individual condition...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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