Changing a patient’s dressing can often be a painful activity. While some may show a high tolerance, other patients may experience extreme distress, also presenting a challenging situation for the treating practitioner. There are primarily four different types of pain experienced by a patient:
- Background pain – referring to persistent pain caused due to wound factors like infection and wound etiology
- Incident pain – this is a result of activities connected to movement, like slippage of dressing or friction.
- Procedural pain- this may occur during routine procedures like changes in dressing
- Operative pain- caused by extra interventions/ procedures to treat the wound
Assessment of patient pain
Pain can be assessed during the first meeting between the patient and the medical practitioner. The type of pain, its location and intensity must be clearly documented and recorded. This should be done before, during as well as after dressing change to determine if there has been any change in the level of pain experienced. This also helps in telling if the measures taken to control pain have been effective or not.
Pain Assessment Tools
Pain assessment tools are primarily used to lay special focus on the pain experienced by the patient. Without this, changes in the level of pain may not be accurately recorded. The medical practitioner uses assessment tools to quantify the patient’s pain and decide a means to control it accordingly.
One can employ numerous pain assessment tools, ranging from verbal, visual analogue to numerical rating scales. The important thing to keep in mind here is that the same scale must be uniformly applied to measure the patient’s pain during repeated visits. In other words, uniformity and consistency are key. By quantifying the pain, the practitioner and patient can together reach a consensus about an acceptable level of pain. Incase the patient experiences pain above and beyond this point, the medical practitioner would try to determine the cause and make dedicated efforts to control it.
Managing Wound Pain During Dressing Changes
There are multiple ways of wound dressing procedure that can effectively reduce the pain experienced during redressing.
- Choose the correct dressing – it is best to choose a dressing that can be easily removed and will not stick to the wound. As opposed to gauze that is more painful, it is recommended to use soft silicone and hydro-fiber dressings that have lesser chances of sticking. If the dressing adheres to the skin, it is best to try a new type of dressing in the next seating. You can find a wide variety of high-quality dressing material at online retailers such as Smart Medical Buyer. From bandages to buying a digital thermometer for baby, this is a one-stop-shop catering to all your medical needs.
- Especially if pain is an issue, the dressing used should be one that doesn’t have to be changed for long. This is possible with strong dressing securement techniques and using products that hurt the skin less during removal.
- The practitioner should not hurry when removing old dressings to redress the wound. If the dressing has got stuck to the wound, the old dressing must be soaked first. Then it can be easily removed without harming the peri wound tissue or wound bed. By using skin barriers along with the correct dressing material, trauma to the peri wound tissue can be greatly reduced and durability of dressing improved.
- Use analgesics before dressing changes – use of analgesics before change of dressing can make a drastic difference to the pain caused by the procedure. The medicine should be administered to the patient long before dressing change is required – only then will the analgesic be effective.
- The patient should participate – giving the patient a chance to take part in decisions aids a feeling of control in their mind. This further helps in pain management. It is best to schedule dress change procedures when the patient is feeling well. The patient should also be given the choice of when/ what time of the day the dressing change should take place.
With these strategies in place, the pain experienced by a patient during dressing change can be drastically reduced and managed. However, it must be kept in mind that pain is an individual experience, and everyone has a different threshold for it. Thus, it is best to keep the patient’s specific condition and desires in mind, also allowing them to participate in decision-making.
Summary
Pain is an individual experience, and everyone has a different threshold for it. However, the pain felt by a patient during change of dressing can be greatly checked with a few important wound dressing techniques.
