Pain management in the intensive care unit.
Pain management is an essential component of quality care delivery for the critically ill patient. Because outcomes are difficult to predict in the intensive care unit (ICU), high-quality pain management and palliative therapy should be a goal for every patient. For those patients actively dying, palliation may be among the main benefits offered by the health care team. Appropriate palliation of pain begins with the use of effective strategies for recognizing, evaluating,and monitoring pain. Skill in pain management requires knowledge of both pharmacologic and nonpharmacologic therapies. This article focuses on expertise in the use of opiates to facilitate confident and appropriate pain therapy. To optimize palliative therapy, symptoms are best addressed by interdisciplinary care teams guided by models that acknowledge a continuum of curative therapies and palliative care.
Mularski
Richard A
RA
Veterans Affairs Greater Los Angeles Healthcare System, Division of Pulmonary & Critical Care Medicine, University of California-Los Angeles, Los Angeles, CA 90073, USA. rmularsk@ucla.edu
D000465:Algorithms; D000698:Analgesia / Q000379:methods / Q000592:standards; D003422:Critical Care / Q000379:methods* / Q000592:standards; D003663:Decision Trees; D004334:Drug Administration Schedule; D006801:Humans; D017146:Models, Organizational; D010146:Pain / Q000175:diagnosis; D059408:Pain Management; D010147:Pain Measurement / Q000379:methods / Q000592:standards; D010166:Palliative Care / Q000379:methods* / Q000592:standards; D010348:Patient Care Team / Q000458:organization & administration; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011383:Progressive Patient Care / Q000458:organization & administration; D011785:Quality Assurance, Health Care / Q000458:organization & administration