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Assessing Pain in the Critically Ill Patient


Whether you are professionally involved with the healthcare industry or not, any individual can empathize with someone experiencing pain. When patients are admitted to a hospital, and in more critical cases the ICU, their comfort and quality of life are of utmost concern to nursing staff and family. However, it is crucial to recognize that not all patients have the ability to properly surmise their level of pain. Earlier this month, the American Association of Critical-Care Nurses (AACN) released a practice alert providing evidence-based recommendations and supporting documentation on how to assess pain in a critically ill patient.

According to the news release, the greatest challenge in assessing pain is that many critically ill patients cannot accurately gauge their pain level due to sedation or mechanical ventilation. This untreated pain can create complications and lead to chronic disabling pain. It can also contribute to  inaccurate pain assessment, or none at all, and can even lead to death.

Family members and hospital staff alike would be interested to know that more than 30% of patients in ICUs have significant pain at rest, and more than 50% experience pain during routine care. In response to this, the practice alert addresses expected nursing practice in regard to pain assessment and will assist hospitals in implementing the “Clinical Practice Guidelines for the Management of Pain, Agitation and Delirium in Adult Patients in the Intensive Care Unit," issued earlier this year by the Society of Critical Care Medicine.

This practice alert will also aid nursing staff attempting to obtain patients' self-reports of pain through a series of tools. For critically ill patients who are unable to self-report their pain level using these tools, nurses will avoid relying primarily on vital signs and instead perform pain assessment using a validated behavioral pain scale or consider asking family members to help identify behavior indicating pain.

As the latest in a series of clinical resources issued by the AACN to support standardization of practice and update the healthcare community on new trends and technologies, the practice alert is directly related to our upcoming Pediatric Critical Care Nursing and Advanced Critical Care Trauma Nursing conferences where you can learn about new technologies being used to better asses, monitor and treat patients. Join us and your colleagues as we explore how clinical practices and evidence-based treatment strategies are incorporated into hospital policies and procedures to better survey patient discomfort.

Comment below to let us know how you feel about pain assessment in the ICU. How do you think the pain of critically ill patients can be better assessed using currently available technologies and standardized practices? To learn more about this AACN alert, please read the news article, "AACN issues practice alert on pain assessment in ICU," found at


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