1. Palliative Care in Critical Care Unit
PCA Pump
Mata, ERA G.
Icn - iiiA

2. Palliative Care in Critical Care Unit PCA Pump
Most common sources of patient distress when dying in the CCU include:
pain
dyspnea
delirium

3. Patient-Controlled Analgesia (PCA)
What is PCA? General use The most common form of this is the paracetamol, that many keep in their bathroom. If a complaint, e.g. a headache, does not resolve with a small dose of painkiller then more may be taken up to a maximum dose.

4. PCA Pump

5. Patient-Controlled Analgesia (PCA)
Hospital use
an electronically controlled infusion pump that delivers a prescribed amount of intravenous analgesic to the patient when he or she activates a button.
Opioids are the medication most often administered through PCAs.
PCA was introduced by Dr. Philip H. Sechzer in the later 1960s and described in 1971.

6. It reduces workload of the nursing staff
Benefits of PCA
It saves time
It reduces workload of the nursing staff
It reduces the chances for medication errors
Patients can receive medicine when they need it

7. Benefits of PCA
Patients who use PCAs report better analgesia and lower pain scores
PCA provides a measurement of how much pain an individual patient is experiencing from one day to the next.
It involves patients in their own care, giving them control and ultimately rendering better patient outcomes

8. Disadvantages of PCAs
Patients may be unwilling to use the PCA or be physically or mentally unable to.
The pumps are often expensive and may malfunction.

9. Who Can Use the PCA Pump? Patients recovering from surgery
Can be used by people coping with other kinds of pain.
Children who are four to six years old Children who are as young as seven can independently use the PCA pump.
Nursing mothers after a cesarean section

10. How Often Should the PCA Pump Be Used?
whenever the patient is feeling pain.
Once the acute pain from surgery is controlled, the patient will be switched to pills for pain relief.
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.

11. When prescribing PCA
Require the use of PCA standard order sets (all sections completed) and limit verbal orders to dose changes.
Always dose PCA opiates in mg or mcg, not by volume (mL).
Check patient allergies before selecting the opiate used with PCA.
Use morphine as the opiate of choice.
Use hydromorphone for patients who need very high doses of opiates.

12. When prescribing PCA
Reserve meperidine for patients who are allergic to both morphine and hydromorphone.
Consider other medications that the patient has received (e.g., analgesics taken at home, intraoperative medications) or currently has prescribed (e.g., antihistamines, nighttime sedatives) when determining the loading and maintenance doses.
Reassess the appropriateness of PCA therapy at regular intervals.