Patient's Pain in Later Life
Conditions
Keywords
arrest or limitation of active treatment, emergency treatment
Brief summary
Decisions to limit and stop active therapeutics are common in the emergency unit. They are framed by the Leonetti law of 22 April 2005 recommending the refusal of unreasonable obstinacy and care of the patient's pain in later life. The pain assessment is an issue for these patients whose in majority, are not communicating. Moreover, no specific tool and the teams in charge, not knowing the patient make the recognition and treatment of pain symptoms very complex. This is the potential interest of directly involving the family or the person of confidence in this management , the first step being the detection and evaluation of pain.
Interventions
None listed
Sponsors
Hospices Civils de Lyon
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults older than 18 * non communicating patients admitted in emergency ward * unanimous decision of stopping and limiting active treatment according to Leonetti's law of April 22nd, 2005 * Presence of a member of the patients family or one of his legal representative
Exclusion criteria
* Children * no health insurance
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| simplified verbal scale | admission time in ER (Day 1) | A simplified verbal scale with 5 levels used by caregivers and family to evaluate the intensity of pain, painless, little sore, moderately painful, very painful, extremely painful. Compare the pain assessment by the family or the person of trust and care teams within a population of non-communicating patients for whom a decision of limiting and stopping active treatment is taken emergency ward. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| simplified verbal scale | 24 hours after the decision of limiting or stopping active treatment in emergencies | A simplified verbal scale with 5 levels used by caregivers and family to evaluate the intensity of pain, painless, little sore, moderately painful, very painful, extremely painful . Compare the pain assessment by the family or the person of trust and care teams within a population of non-communicating patients 24 hours after the decision of limiting or stopping active treatment in emergencies |
| Algoplus scale | at admission (Day 1) | Comparison of pain assessment between families and caregivers with support will be made using Algoplus scale defining a pain when the score is greater than 2. Compare the pain assessment by the family or the person of trust and care teams with the support of a rating scale in a population of non-communicating patients for whom a decision of limiting or stopping active treatment in emergencies. |
| PAINAD scale | at admission (Day 1) | Comparison of pain assessment between families and caregivers with support will be made using PAINAD scale rated from 0 to 10, defining the intensity of pain. Compare the pain assessment by the family or the person of trust and care teams with the support of a rating scale in a population of non-communicating patients for whom a decision of limiting or stopping active treatment in emergencies |
| CAESAR scale | 24 hours after admission | Assess the feelings of nursing teams on the family involvement in the assessment of pain and not communicating patient discomfort for which is a determination of limiting or stopping active treatment in emergencies. |
Countries
France
Contacts
Primary ContactLaurent JACQUIN, MD
Backup ContactJulien BERTHILLER
Outcome results
None listed