Patient Controlled Analgesia (PCA) What you need to know?

Safe and effective pain management is fundamental in the care of hospitalized patients. The use of patient-controlled analgesia (PCA) is common in clinical practice–but not without associated hazards and risks.

Common side effects of PCA:

Sleepiness

Nausea and vomiting

Itching

Constipation

Is it Safe?

PCA pumps have built-in safety features. The total amount of analgesic(pain reliever) that the patient can self administer is within a safe limit.

How Often Should the PCA Pump Be Used?

The pump can be used whenever the patient is feeling pain.

How do I use the PCA pump?

A nurse will show how to use the PCA button. Ask a nurse for assistance if you are having trouble using the PCA button.

How does PCA work?

A PCA pump is connected to your intravenous. When you have pain, you press the PCA button and you will receive a dose of pain medication. The medicine will take 5 to 10 minutes to work. For safety, once you have triggered a dose of pain medication, a set time must pass (about 6 minutes before another press of the button will trigger another dose of medication.

Other pain medications such as acetaminophen or ibuprofen may also be given at regular time.

When should I push the PCA button?

Press the button when you start to feel pain or before you do something that brings on the pain, such as: your breathing and coughing exercises, or you start to move or turn. Before physiotherapy or if you are getting out of bed to sit in the chair or go for a walk. DO NOT wait until your pain is bad before using your PCA pump.

When shouldn't I use the PCA button?

Do not use the PCA:

to help you sleep

to calm you down

to relieve gas pains

Do I have to stay in bed with a PCA pump? You will be able to get up out of bed, go to the washroom and walk in the halls with the PCA pump.

Can I give myself too much medication? It would be unusual for you to give yourself too much medication provided you use it appropriately and no other individuals push the PCA button for you. Your doctor has ordered the amount of pain medication you should receive. Every time you feel pain you should push the button. The PCA pump is programmed and will not give you pain medication if it is not time for a dose. DO NOT use your own pain meds or sleeping pills from home while using the PCA.

Who should press the PCA button?

ONLY YOU SHOULD PRESS THE PCA BUTTON!

Family and visitors SHOULD NOT press the PCA button for you. If you cannot press the PCA button, notify your nurse.

What if I am still having pain after receiving my pain medication?

It may take 2 to 3 doses before the pain medication controls your pain. If you are still having pain, call the nurse and your dose of pain medication may be changed. The nurse will ask you to describe your pain, using this pain scale as a guide.

Patients who are candidates for post-surgical use of PCA should be trained prior to admission for their surgery. However, many patients only learn about PCA when they awaken from anesthesia and a nurse in the post-anesthesia care unit is explaining it to them for the first time. As part of the pre-admission process, patients and their families must be taught the relationship between pain, pushing the button, and adequate pain relief. They should understand the benefits of PCA and how it works. They also should be shown that the pain control button differs in appearance from the nurse call button.

References:

http://www.stjoe.on.ca/about/publications/pdf/brochures/pca.pdf

http://www.webmd.com/pain-management/guide/pca

http://www.carefusion.com/

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