Pain in the Intensive Care Unit: Nursing Issues

Abstract

A stay in an intensive care unit is a frequent source of distress for patients, because of its specificity (invasive treatments) and context (risk of death). Associated with anxiety and fear, pain causes an acute stress response with deleterious short-term physiological and behavioral effects, as well as an increased risk of posttraumatic stress disorder in the long-term. In fact, patient's pain can be considered as a parameter to be monitored in the same manner as physiological data such as heart rate, blood pressure, urine output, or temperature. Repeated assessment of pain intensity using validated pain tools allows for better therapeutic management in critically ill patients: the stress response (tachycardia, hypoxemia, etc.) is reduced by improved analgesia; and the drug-related side effects are less frequent because analgesics’ dose is more adequately adjusted. Moreover, screening pain as an alarm symptom is part of the global diagnosis management of patients. Such an optimized diagnosis and therapeutic approach to pain requires a team consensus that can easily be associated with health care quality projects and risk management processes.