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Pain Assessment of Elderly Patients with Cognitive Impairment in the Emergency Department: Implications for Pain Management—A Narrative Review of Current Practices
Elderly people are susceptible to both falls and cognitive impairment making them a particularly vulnerable group of patients when it comes to pain assessment and management in the emergency department (ED). Pain assessment is often difficult in patients who present to the ED with a cognitive impair...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5597155/ https://www.ncbi.nlm.nih.gov/pubmed/28970442 http://dx.doi.org/10.3390/pharmacy5020030 |
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author | Jones, Joshua Sim, Tin Fei Hughes, Jeff |
author_facet | Jones, Joshua Sim, Tin Fei Hughes, Jeff |
author_sort | Jones, Joshua |
collection | PubMed |
description | Elderly people are susceptible to both falls and cognitive impairment making them a particularly vulnerable group of patients when it comes to pain assessment and management in the emergency department (ED). Pain assessment is often difficult in patients who present to the ED with a cognitive impairment as they are frequently unable to self-report their level of pain, which can have a negative impact on pain management. This paper aims to review how cognitive impairment influences pain assessment in elderly adults who present to the ED with an injury due to a fall. A literature search of EMBASE, ProQuest, PubMed, Science Direct, SciFinder and the Curtin University Library database was conducted using keyword searches to generate lists of articles which were then screened for relevance by title and then abstract to give a final list of articles for full-text review. Further articles were identified by snowballing from the reference lists of the full-text articles. The literature reports that ED staff commonly use visual or verbal analogue scales to assess pain, but resort to their own intuition or physiological parameters rather than using standardised observational pain assessment tools when self-report of pain is not attainable due to cognitive impairment. While studies have found that the use of pain assessment tools improves the recognition and management of pain, pain scores are often not recorded for elderly patients with a cognitive impairment in the ED, leading to poorer pain management in this patient group in terms of time to analgesic administration and the use of strong opioids. All healthcare professionals involved in the care of such patients, including pharmacists, need to be aware of this and strive to ensure analgesic use is guided by appropriate and accurate pain assessment in the ED. |
format | Online Article Text |
id | pubmed-5597155 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-55971552017-09-29 Pain Assessment of Elderly Patients with Cognitive Impairment in the Emergency Department: Implications for Pain Management—A Narrative Review of Current Practices Jones, Joshua Sim, Tin Fei Hughes, Jeff Pharmacy (Basel) Review Elderly people are susceptible to both falls and cognitive impairment making them a particularly vulnerable group of patients when it comes to pain assessment and management in the emergency department (ED). Pain assessment is often difficult in patients who present to the ED with a cognitive impairment as they are frequently unable to self-report their level of pain, which can have a negative impact on pain management. This paper aims to review how cognitive impairment influences pain assessment in elderly adults who present to the ED with an injury due to a fall. A literature search of EMBASE, ProQuest, PubMed, Science Direct, SciFinder and the Curtin University Library database was conducted using keyword searches to generate lists of articles which were then screened for relevance by title and then abstract to give a final list of articles for full-text review. Further articles were identified by snowballing from the reference lists of the full-text articles. The literature reports that ED staff commonly use visual or verbal analogue scales to assess pain, but resort to their own intuition or physiological parameters rather than using standardised observational pain assessment tools when self-report of pain is not attainable due to cognitive impairment. While studies have found that the use of pain assessment tools improves the recognition and management of pain, pain scores are often not recorded for elderly patients with a cognitive impairment in the ED, leading to poorer pain management in this patient group in terms of time to analgesic administration and the use of strong opioids. All healthcare professionals involved in the care of such patients, including pharmacists, need to be aware of this and strive to ensure analgesic use is guided by appropriate and accurate pain assessment in the ED. MDPI 2017-06-01 /pmc/articles/PMC5597155/ /pubmed/28970442 http://dx.doi.org/10.3390/pharmacy5020030 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Jones, Joshua Sim, Tin Fei Hughes, Jeff Pain Assessment of Elderly Patients with Cognitive Impairment in the Emergency Department: Implications for Pain Management—A Narrative Review of Current Practices |
title | Pain Assessment of Elderly Patients with Cognitive Impairment in the Emergency Department: Implications for Pain Management—A Narrative Review of Current Practices |
title_full | Pain Assessment of Elderly Patients with Cognitive Impairment in the Emergency Department: Implications for Pain Management—A Narrative Review of Current Practices |
title_fullStr | Pain Assessment of Elderly Patients with Cognitive Impairment in the Emergency Department: Implications for Pain Management—A Narrative Review of Current Practices |
title_full_unstemmed | Pain Assessment of Elderly Patients with Cognitive Impairment in the Emergency Department: Implications for Pain Management—A Narrative Review of Current Practices |
title_short | Pain Assessment of Elderly Patients with Cognitive Impairment in the Emergency Department: Implications for Pain Management—A Narrative Review of Current Practices |
title_sort | pain assessment of elderly patients with cognitive impairment in the emergency department: implications for pain management—a narrative review of current practices |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5597155/ https://www.ncbi.nlm.nih.gov/pubmed/28970442 http://dx.doi.org/10.3390/pharmacy5020030 |
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