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Table 3 Strategies used to assess and treat agitation and pain

From: Current practices and barriers impairing physicians’ and nurses’ adherence to analgo-sedation recommendations in the intensive care unit - a national survey

 

Total, % ( n ) a

Physicians, % ( n ) b

Nurses, % ( n ) c

Availability of a written analgo-sedation protocol (= Yes)

31 (281)

41 (131)

26 (150)

Frequency of use of analgo-sedation protocolsd

   

 Never

6 (16)

3 (4)

8 (12)

  <1×/day

27 (76)

21 (27)

33 (49)

 1×/day

28 (80)

40 (53)

18 (27)

  >1×/day

38 (107)

36 (47)

40 (60)

Availability of a sedation scale (= Yes)

86 (773)

82 (265)

88 (508)

Type of sedation scales usede

   

 RASS

20 (152)

24 (64)

17 (88)

 SAS

13 (102)

13 (34)

13 (68)

 MAAS

1 (7)

2 (6)

0 (1)

 Ramsay sedation scale

64 (491)

69 (184)

60 (307)

 GCS

59 (456)

54 (142)

62 (314)

 Other sedation scalef

13 (103)

9 (24)

16 (79)

Frequency of use of sedation scales on a given patient per daye

 Never used, irregularly used, <1×/day

8 (59)

8 (21)

7 (38)

 1 to 2×/day

9 (67)

14 (38)

6 (29)

 3 to 5×/day

36 (276)

46 (122)

30 (154)

 6 to 11×/day

30 (233)

26 (68)

32 (165)

 12×/day

13 (98)

3 (7)

18 (91)

  > 12×/day

4 (29)

2 (5)

5 (24)

 Other

0 (2)

0 (1)

0 (1)

Reported indications for using sedation scales

   

 To assess the level of sedation

93 (839)

90 (291)

95 (548)

 To adjust dosage of sedatives

73 (657)

77 (249)

71 (408)

 To assess the level of pain

37 (333)

43 (139)

34 (194)

 To adjust dosage of analgesics

33 (299)

38 (123)

31 (176)

Use of daily sedation interruption

   

 Never

31 (282)

22 (70)

37 (212)

 Used in <25% of the patients

44 (393)

38 (122)

47 (271)

 Used in 25 to 75% of the patients

17 (149)

25 (80)

12 (69)

 Used in >75% of the patients

5 (45)

9 (28)

3 (17)

Opiates are stopped during daily sedation interruption (= Yes)g

40 (249)

34 (85)

45 (164)

Assessment of analgesia in patients unable to self-report

 No assessment

7 (59)

4 (12)

8 (47)

 Through physiological parameters

88 (787)

80 (257)

92 (530)

 Through behavior

85 (765)

81 (263)

87 (502)

 During daily sedation interruption

42 (373)

47 (151)

39 (222)

 Post-analgesia

55 (492)

46 (150)

59 (342)

 BPS

9 (84)

10 (32)

9 (52)

 CPOT scale

2 (18)

2 (6)

2 (12)

 Other pain scaleh

19 (172)

9 (30)

25 (142)

  1. ATICE, Adaptation to the Intensive Care Environment, BPS, Behavioral Pain Scale; CPOT, Critical Care Pain Observation Tool; GCS, Glasgow Coma Scale; MAAS, Motor Activity Assessment scale; RASS, Richmond Agitation and Sedation Scale; SAS, Sedation Agitation Scale. aNumber does not total 898 because not all respondents answered each item. bNumber does not total 323 because not all respondents answered each item. cNumber does not total 575 because not all respondents answered each item. dNumber totals only those with an analgo-sedation protocol available. eNumber includes only those with a sedation scale available within their unit. Some respondents have indicated the use of more than one scale. fRespondents were asked to indicate any other scale used (for example: ATICE, 1% (7); Bloomsbury, 2% (14); Brussels, 2% (18)). gNumber totals only those using daily sedation interruption. hRespondents were asked to indicate any other scale used (for example: ATICE, 1% (7); DOLO-USI, 13% (113); Visual Analogic Scale, 14% (119)).
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Critical Care

ISSN: 1364-8535