Some veterinarians still say that surgical pain management is optional and that the pet owner should decide whether to administer
it. I disagree. Relieving pain is a medical decision that must be made by a medical professional. Our patients need and deserve
mandatory pain management in the perioperative period.
3. Assess pain in every patient at every visit, and document it.
Apply your chosen pain scoring system. At every outpatient visit, assess the animal for pain, and record the finding in the
medical record. Each pain assessment is important, but trends are even more important for patients with chronic pain—are they
improving or worsening?
Similarly, surgical patients with acute pain need to be assessed at regular intervals during their hospital stays and need
to have their results recorded in their medical records. Seeing trends allows the practice team to understand the success
of a perioperative pain management plan.
4. Remember the three Rs of chronic pain management: recheck, reassess, and revise.
For patients with chronic pain, pain management is often a moving target. Patient pain management needs may change with the
seasons, the temperature outdoors, and the patient's activity level. Managing chronic pain remains a dynamic process that
relies on the three Rs:
- Recheck the patient at regular intervals. Schedule the next recheck before the client leaves at the end of a visit;
- Reassess the patient's comfort level, based on the current therapeutic plan;
- Revise your pain management plan according to the patient's needs.
5. Join the International Veterinary Academy of Pain Management (IVAPM).
The entire veterinary healthcare team is welcome to join the IVAPM. IVAPM members have access to sections of the Web site
containing downloadable pain management training programs and links to articles of interest. And members can subscribe to
Veterinary Anaesthesia and Analgesia at a discounted rate. The members' list serve actively discusses pain cases of interest, new applications of old medications,
and nonmedical pain management.
The IVAPM is developing a credentialing pathway for interested veterinarians and veterinary technicians to demonstrate expertise
in pain management.
IT STARTS AT THE TOP
Making pain management a priority in your practice means every team member has an important role to play in identifying pain
in every pet. Since the team walks in the shadow of the leader, a commitment to pain management and prevention starts at the
top. Relieving pain is compassionate care at its best and is both a quality-of-care and a quality-of-life issue. Inspire your
team to share your passion for doing the right things right for pets in pain!
The path to high quality care: practical tips for improving compliance. Lakewood, Colo: American Animal Hospital Association, 2003.