title: [Pain behaviour indicator scale (ESCID) application in severe non-communicative trauma patients receiving mechanical ventilation].
abstract: OBJECTIVE
  To assess pain in non-communicative patients with severe trauma undergoing mechanical ventilation prior to, during and after tracheal suctioning, mobilization and wound care.
  
  
  METHODS
  A prospective and observational study from October to December 2011 was performed. Study variables were ESCID scale and monitoring of vital signs (blood pressure, heart rate, and respiratory rate). Data were gathering 5 minutes before, during and 15 minutes after the 3 procedures. The nursing evolutive report recorded pain assessment, administration and effectiveness of the analgesia. Descriptive analysis of variables included Student's T test/ANOVA for multivariate analysis with SPSS 17.0.
  
  
  RESULTS
  A hundred eighty four observations: 46.8% tracheal suctioning, 38.5% mobilization and 14.7% wound care were performed in 29 patients. ESCID score was 0.4±1 before, 3.4±2.7 during and 0.4±1 after for wound care; 0.4±1.1 before, 3.6±2.2 during and 1.1±0.5 for tracheal suctioning; 0.5±1.1 before, 3±2.8 during and 0.2±0.8 after for mobilization. These increased significantly during the performance of the 3 procedures before-during/during-after: P=.000. All the hemodynamic variables were significantly modified during mobilization and tracheal suctioning: before-during/during-after: P=.000, with the exception of the cures that only affected respiratory rate. 27% of the procedures received analgesia: 9% received it before, 15% during and 3.2% after, with more analgesia being required for the wound care (33.3%). The data collected in the nursing report on the evaluation of pain/effectiveness of the analgesia showed 20.66%.
  
  
  CONCLUSIONS
  An increase on the ESCID score was observed while performing the procedures.
authors.affiliation: UCI de Trauma y Emergencias, Hospital Universitario 12 de Octubre, Madrid, España. Electronic address: candelas.lopez@salud.madrid.org.
authors.forename: C
authors.initials: C
authors.lastname: López López
authors.forename: M A
authors.initials: MA
authors.lastname: Murillo Pérez
authors.forename: S
authors.initials: S
authors.lastname: Torrente Vela
authors.forename: C
authors.initials: C
authors.lastname: Cornejo Bauer
authors.forename: M
authors.initials: M
authors.lastname: García Iglesias
authors.forename: M
authors.initials: M
authors.lastname: Orejana Martín
authors.forename: C
authors.initials: C
authors.lastname: Morales Sánchez
authors.forename: M
authors.initials: M
authors.lastname: Cuenca Solanas
authors.forename: E
authors.initials: E
authors.lastname: Alted López
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D011446:Prospective Studies; D012121:Respiration, Artificial; D012720:Severity of Illness Index; D014947:Wounds and Injuries; D055815:Young Adult
keywords: Dolor; Mechanical ventilation; No comunicativo; Non-communicative; Pain; Severe trauma; Trauma grave; Ventilación mecánica