Patient Controlled Analgesia Essay Example | Topics and Well Written Essays - 2500 words

Patient Controlled Analgesia - Essay Example 1989). This was first introduced in 1970 into obstetric practise where the patient simply controlled the administration of i.v. pethidine by operation of a spring loaded clamp on an infusion set! In a way, it mimics the use of the PCA 50:50 nitrous oxide/oxygen gas mixture (Entonox). Patient Controlled Analgesia refers to a particular type of breakthrough dosing used when a predetermined parenteral drug dose is injected following the push of a button. In reality not all PCA breakthrough doses are controlled or administered by patients, who may be physically or mentally impaired. Clinicians or families may administer the breakthrough dose in such cases, which is still often (erroneously) called the PCA dose. Thus, in practice parenteral breakthrough doses, when programmed by a pump are often referred to as PCA doses, regardless of who administers the dose. In a general sense, patient-controlled analgesia refers to a process where patients can determine when and how much medication the y receive, regardless of analgesic technique. On the other hand, the term is more commonly used to describe a method of pain relief which uses disposable or electronic infusion devices and allows patients to self-administer analgesic drugs, usually intravenous (i.v.) opioids, as required. Patient-controlled analgesia produces a modest improvement in pain relief over a 24 hour period compared with conventional analgesia. It is preferred by patients, and is not associated with additional side effects. For many patients, mainly those having major abdominal surgery, PCA offers the greatest pain relief and the most flexibility. A PCA device consists of a pump, a reservoir to hold the drug and a handset with a button that administers a dose of drug when activated by the patient. Patient receives pain medication by pressing a button permitting the patient to take control of the pain. This eases the anxious waiting for pain relief and the peaks of pain (Macintyre PE, Runciman WB, Webb RK. 1 990). Patient controlled analgesia is widely used for postoperative pain relief in both children and adults. Unfortunately, postoperative pain control is often the last concern discussed with patients even though it can become the major concern after the operation is performed. Most patients are more worried concerning the potential surgery and anaesthetic complications prior to surgery, than they are with pain control after surgery. Therefore, patients are often overshadowed by the patient's anxiety regarding the procedure Postoperative pain management actually starts preoperatively. The anaesthesiologists and surgeon will decide on a plan prior to the surgery. A major deciding factor with regard to choosing an appropriate plan will depend on whether the patient is to be discharged the same day (day surgery) or will be admitted after surgery. With right preoperative teaching and encouragement, children as young as 6 to 7 years of age can independently use the PCA pump to provide good post operative pain relief (Kluger and Owen H. 1990). Children between the ages of 4 and 6, though, generally require encouragement from the parents and nursing staff to push the button before anticipated painful movements or

What is Epistemology Essay Example | Topics and Well Written Essays - 2000 words

What is Epistemology - Essay Example The link of epistemology into ontology and the way epistemology shape social research in general. According to scientists, there is a significant difference between too expressions: â€Å"I know that† and â€Å"I know how†. For instance, it is well-known that 1+1=2, however, here we could think not only about the result, but about the process itself: how there two numbers should be summed up. When we state that we â€Å"know† something, the question arises why we â€Å"believe† that. When we â€Å"believe’ in something we usually think that this â€Å"something† will not make us disappointed, for example we may believe in our national basketball team and its victory. However, epistemology considers â€Å"belief† from another point of view. For example, when we believe that the grass is green that means that we consider the statement that the grass is green to be correct. Every statement is simply a preposition of someone else and it does not mean that everybody must believe it .At the same time, if something represents a real fac t, it is true. The main controversy in this area is concentrated on study of the nature of knowledge and its connection to related concepts: information, conviction, and rationalization. It is connected with the method of knowledge acquisition and uncertainty about various statements. The different arguments of rationalism and empiricism and the controversy that occurs on the base on this difference is connected to different experience of the people in their attempts to obtain knowledge. According to rationalists, there are significant methods to obtain information autonomously of experience at the same time as empiricists consider experience to be very essential in knowledge acquisition (Fodor 1975). The vision of rationalists is usually built in the following way: they state that sometimes our knowledge obtained through intuition is more reliable, than that obtained from experience. Then,