10.07.2015 Views

Physical Physical - Tripawds Downloads

Physical Physical - Tripawds Downloads

Physical Physical - Tripawds Downloads

SHOW MORE
SHOW LESS
  • No tags were found...

Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

Today’s Technician |Pain assessment in dogs & catsFigure 3. Painful, postoperative thoracotomy patient;note the facial expression with grimace and furrowedbrows. Courtesy Holly Killian, CvTFigure 4. Patient from Figure 3 resting morecomfortably after a dose of analgesics.Courtesy Holly Killian, CvTmake serial assessments of a patient’s pain toreduce the possibility of interobserver variability.• Develop a specific pain assessment protocol thatallows all personnel to use the same parametersto assess patient pain.visual Pain AssessmentPrior to Examination• The patient should be evaluated from a distanceprior to handling to avoid changes in behaviorresulting from human proximity. 15,16• While observing, the respiratory rate and patternof breathing should be noted.• Posture, facial expression, position of ears, andtenseness of body should all be observed as theymay change significantly once the caregiver interactswith the patient.Examination Room• In an examination room setting, it may be beneficialto observe and examine the patient bothwith and without the owner present. For example,animals that are frightened or suffer from separationanxiety may be easiest to examine with theowner in the room.• Pet owners should be asked about their animal’snormal behavior at home and how they havereacted to pain previously. This allows better painassessment during physical examination and hospitalstay.In the Hospital• Some hospitalized patients will let down theirguard and allow signs of pain to be observed.• However, there are many that never relax whilehospitalized, and subsequently are much moredifficult to accurately assess.• There are also animals that maintain their inherentsurvival mechanism, which causes them to hideany sign of weakness, including pain. These stoicdogs can appear deceptively relaxed and comfortable,despite being in significant pain.<strong>Physical</strong> examinationA thorough physical examination should be performedafter the initial visual examination. However, theimportance of physical examinations to assess patientpain must be balanced against the possibility of causinga patient further stress with repeated handling.• Gentle and compassionate handling of the patientduring the examination is vital, particularly ifpatient pain is anticipated.• Potentially stressful procedures, such as checkingrectal temperature, should be performed at theend of the examination, if possible.• If the source of pain is already known, the rest ofFigure 5. A patient resting comfortably in the hospitalMarch/April 2012 Today’s Veterinary Practice 71

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!