The functions of the PCA Administer small bolus doses of Pain-control drugs At fixed intervals

2. The functions of the PCA • Administer small bolus doses of • Pain-control drugs • At fixed intervals • Controlled by the patient • with the push of a button

3. Four Dimensions of Pain • Sensory-discriminative • Motivational-affective • Cognitive-evaluative • Social-behavioral

4. Problem: Detecting pain • Subjective & no direct measurement • Clinical: Visual Analogue Scales (VAS) • Numerical Rating Scales (NRS) • Verbal Rating Scales (VRS) • Questionnaire

5. Descriptivepain scales Mild Moderate Severe No pain Worst possible pain Numeric pain scales 0 10 Worst possible pain 1 2 3 4 5 6 7 8 9 No pain 0 Visual analog scale (VAS) 10 Pain as worst as it could be No pain Pain Intensity Scales

6. 疼痛強度  完全不痛  輕微痛  非常痛  無法忍受 疼痛種類  酸脹  痠軟  緊繃  抽筋  冰冷  灼熱  放電  切割  麻癢  撕裂 完全不痛 無法忍受 正面 VAS VRS 疼痛量尺 (正面)

7. 完全不痛 無法忍受 反面 疼痛量尺 (反面)

8. Evaluation: face scales

9. McGill Pain Questionnaire • 4 groups of descriptors: • Sensory: 1-10 • Affective: 11-15 • Evaluative: 16 • Miscellaneous: 17-20 • Pain rating index (PRI) • Present pain intensity (PPI): 0-5

10. The Disadvantage of these methods: • Static Pain (not Dynamic Pain) • Maybe, the VAS values are similar but • the efforts are totally different • Time Consuming • The On-line Analyzing Pain is impossible Pain has become the “Fifth vital Sign” Patient’s chart : BP, HR, RR, and T

11. i-Pain: Information, Intelligence, Interaction

13. Pain has become the “Fifth vital Sign” VAS NRS VRS Button-pressing profile PCA Patient pain scores (between 0~10) controlled by patient (a) BP Pain Pattern Fuzzy Model Algorithm SP FPR index (between0~10) ZP pain Button-pressing profile PCA Patient (b) Patient’s chart : BP, HR, RR, and T bolus infusion Figure1. Block diagram of modelling pain system to interpret the pain measurement (a) Conventional PCA system; (b) PCA+FPR system

14. PCA病患自控止痛系統 資料接收 病患基本資料 檢視及輸出 調劑紀錄 選項 副作用 巡房紀錄 上傳至Server (via Internet) The i-Pain System:

15. 病患基本資料

16. 檢視及輸出

17. PDA for Interviewing Patients Applied in the assessment of postoperative pain

18. The Advantages of Using PDA for Interviewing Patient • Small，Light，Portable • High Technology、Fancy • Search and save data easily • Data can be shown in Figures • Pain Location : Displaying an anterior and posterior view of the body • VAS Score: Displaying an VAS image to the patient

21. Abbott程式引入PDA部分 已經引入BPI的功能

22. 將PDA的程式引入BPI PC部分 PDA部分

23. Data Communications: PCA USB RS232 PDA IrDA Computer RF

24. PDA as a Messenger for Data Collection PC PCA PDA

25. Conventional Interviewing System(Paper Pain Diary) Current Interviewing System

26. PDA Interviewing System(Electronic Pain Diary)

27. 台北榮總 PCA 10182 病歷資料10815 MATCH 3890 台大醫院 PCA 806 病歷資料276 MATCH 211 新光醫院 PCA 3807 病歷資料2257 MATCH 2212 亞東醫院 PCA 178 病歷資料101 MATCH 101 成大醫院 PCA 300 病歷資料298 MATCH 292 慈濟醫院 PCA 病歷資料 MATCH 奇美醫院 PCA 2579 病歷資料2539 MATCH 2480 中國醫藥學院 PCA 1594 病歷資料3968 MATCH 1342

28. Future works: • Mining the Web Information • for Actionable Knowledge • (Dosage Amount, Different Drugs, • Lockout Intervals,VAS,Side Effects) • The Real Time of TQPM RS-232 PCA Receive Tablet PC or PDA

29. Pain Diary