TOPIC FIVE: PAIN

(See section on Pain under Patient Assessment)

The International Association for the study of Pain (2014) sets out the following minimum standards for practitioners: they should have the knowledge of pain theories and mechanisms, types of pain and what influences patients’ perception of pain and, in practice, have the ability to assess pain and the methods for relieving pain.

Pain may be associated with the underlying pathology, be related to the dressing or therapy or arise in anticipation of a painful procedure. The type, time of onset, frequency, and severity of pain, as well as how patients cope with pain, should be assessed and documented (Benbow, 2016). Various pain assessment tools have been developed.

It is important that pain as a result of the wound must be assessed and the appropriate action taken to make the patient comfortable, and to encourage wound healing. This will depend on the type of wound being assessed, as the cause of pain will often depend on the underlying aetiology of the wound.

Dressing change and other wound management activities, such as debridement, are known to cause pain. Most analgesics can be administered before a painful event, but clinicians should ensure that other drug options are available to deal with the pain that becomes uncontrollable (WUWHS, 2004).

Unexpected pain and tenderness at the time of dressing change may be a sign of infection (Cutting & Harding, 1994). If, after careful assessment, it is apparent that the wound is infected, it is important to confirm this and identify the causative organism and sensitivities to antibiotics (Collier, 2004).