An 3Clinical Reasoning

Pain Assessment and Management

Assessor

PGY4+

Due

Week 7

Requirement

Optional

What Assessors Look For

Systematic pain assessment
Understanding of pain types (nociceptive, neuropathic)
Multimodal analgesia approach
Safe opioid prescribing
Recognition and management of side effects

Key Points to Demonstrate

1Assessment: location, character, severity (0-10), timing, aggravating/relieving factors
2WHO pain ladder: paracetamol → weak opioid → strong opioid (but multimodal better)
3Multimodal: paracetamol + NSAID (if appropriate) + opioid PRN
4Opioid equivalence: oral morphine 10mg = oxycodone 7.5mg = IV morphine 3-5mg
5Side effects: nausea, constipation, sedation, respiratory depression
6Special populations: renal impairment, elderly, opioid-naive vs tolerant

Tips for Success

  • 💡Always ask about allergies and previous pain medications
  • 💡Start low, go slow - especially in elderly and renal impairment
  • 💡Prescribe anti-emetics and laxatives with opioids

Study Resources