Protocols and advice on general pain management for patients were discussed at the latest Grand Rounds at Weill Cornell Medicine-Qatar (WCM-Q) by Dr Karunakaran Ramaswamy, attending physician at Sidra Medicine.
Dr Ramaswamy explained that physicians treating patients who are in pain should follow a sequence that begins with one very simple but effective step.
Acknowledging someone’s pain is very important. If you are suffering and someone stops what they are doing, comes to you and says, ‘oh, you are in pain, let me help,’ it immediately makes you feel comforted. The effectiveness of this simple step should not be underestimated. This is all the more important when we consider that if you go to any hospital in the world, about 60 to 70 per cent of patients there are in pain at any given time.
Dr Ramaswamy also discussed other simple but effective measures to help patients in pain, such as offering patient a comfortable seat, a cold or warm compress and a drink. Once these measures are in place, the physician should then determine the severity of the pain and then begin to consider offering analgesic or painkilling medications.
He discussed the analgesic ladder of the World Health Organization, which explains which types of drugs to use for pain of differing levels of severity.
But simply masking pain is not sufficient, said Dr Ramaswamy. More important is the point: what is the thing that is causing pain?
That is what we need to worry about because when we give painkillers, yes, it’s masking the pain, but that’s not going to cure the pain. But until we can treat the pain, we must use all the modalities available to us to manage the pain.
Dr Ramaswamy explained the physiology of pain, the importance of listening carefully to patients’ accounts of their pain, and the effectiveness of multi-disciplinary approaches to pain management, involving a variety of different health professionals, such as an acute pain nurse, a physiotherapist, a clinical psychologist and a specialist physician. He added that treating pain is not just about writing a prescription.
It’s about treating a patient as a whole, not just addressing one symptom.
The lecture, titled General Pain Management was accredited locally by the Qatar Council for Healthcare Practitioners-Accreditation Department (QCHP-AD) and internationally by the Accreditation Council for Continuing Medical Education (ACCME).