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Module12

Pain

Overviewofpain
Pain+fearcloselyinterrelated Painoftenassociatedwithillness/trauma Feargenerallythoughtofinrelationtooncomingpain/outcomeofdamage Oftenhelpfultoencouragept.toexpresspainsandfears Expressionbeingsprocessofadjustmenttopain+acceptanceofemergencymedicalcare

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HistoryofPain

Obtainfullaspossiblehistoryfrompt. Asktheflowingquestions:OPQRST Onset Whendidthepainstart/begin? Provokes Whatprovokesthepain? E.g.wasthept.exercising? Quality Whatisthequalityofpain? Crushing/stabling/dull/sharp/burning/throbbingfeelslikesomeoneissittingon theirchest Radiation/Radiating Isthepainradiating? i.e.tothejaw,arms,abdomen,back Severity Howseveristhepain? Scaleof110?10beingtheworsethept.haseverfelt Time Howlonghasthepainlasted? 1hour Andisthepainconstantordoesitcomeandgoandforhowlong

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TypesofPain Focalpain
o Paininsingleplace(fractures/inflammation)

Diffusepain
o Painingeneralareanotspecific(MI/internalbleeding)

Radiatingpain
o PainradiatestoanotherareaAMI

Sensationmaybediminishedinelderpt.leadingtounderestimatingseverityofcondition 20%30%havesilentheartattacksnoassociatedheartpains Painreliefisimportantaspectoftreatment o Notonlyforhumanitarianreasons o Alsobecausepainitselfispotentiallyharmful PainactivatesbodiesANSSympatheticandparasympatheticNervesSystem(fight/flightresponse) o Promotingoutpouringofadrenalineinalreadyovertaxedsystem o Highlydesirabletorelievept.painfromallpointsofview

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Module12

Pain

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TypesofAbdominalPain Visceralpain
Resultfromstretchonautonomicnervefibresthatsurroundabdominalviscera Distensionofholloworgans Crampy/dull/gassy Tendstobepoorlylocalizedcomeandgoes

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Somaticpain
Resultsfromnervefibresinperitoneumirritatedbyinflammation Sharppain Tendstobeconstant+provokedbycoughingorjarringmotion

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Referredpain
Anypaininlocationdistantfromdiseasesorgan E.g.irritationofdiaphragm o Resultinneckandshoulderpain NOTALLABDOMINALPAINISFROMABDOMINALCAUSES

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