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<p><b>New page</b></p><div>__NOTOC__<br />
Which of the following patients is NOT in “pain”, as defined by the IASP (and<br />
discussed above):<br />
<br />
a) A 13 year-old female with crampy abdominal discomfort<br />
<br />
b) A 12 day-old male crying with an incarcerated inguinal hernia<br />
<br />
c) A 5 year-old female who cries when approached for IM vaccination<br />
<br />
d) A 23 year-old man complaining of lumbar back pain and asking for a “work<br />
note” despite normal physical exam and radiographic findings<br />
<br />
e) A 24 month-old male crying and refusing an IV placement<br />
<br />
f) All of the above are in pain<br />
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==Answer==<br />
Answer f. Pain is defined by the IASP as “an unpleasant sensory and emotional<br />
experience associated with actual or potential tissue damage, or described in<br />
terms of such damage.” Importantly, patients do not have to be able to verbalize<br />
the experience in order to be in pain. Equally important is the concept that pain<br />
is always subjective. In other words, whatever the patient says the level of pain<br />
is, it is. Fear of IV or IM needles (and potential tissue damage) qualifies as pain<br />
by this definition. While the patient described in (D) may warrant investigation<br />
as to possible ulterior motives (such as opioid-seeking or malingering), in the<br />
meantime his pain symptoms should be assumed to be as he describes them and<br />
treated appropriately.<br />
==Notes==<br />
<references /><br />
:This question originally printed in the [http://www.amazon.com/Justin-L.-Lockman/e/B00FLG5AEE/ref=ntt_dp_epwbk_0 Pediatric Anesthesiology Review Topics] kindle book series, and appears courtesy of Naerthwyn Press, LLC.<br />
==Keywords==<br />
:<br />
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