Disinfection of a blood pressure measuring cuff

334 Textbook of Nursing Science Chapter 14 Vital Parameters 335 Today, the electronic measurement methods applied

ac-cording to the method reviewed in connection with the ex-travasal pressure sensors are accepted as up-to-date methods.

b

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Introduction

Pain is present in our life from the time we are born. As a new-born baby and as an infant pain manifests itself as an instinc-tive behavioural pattern which is demonstrated in crying, whereas in adults it is accompanied by conscious, analytical, determining type of behaviour. In the course of evolution pain has accompanied humanity and every era had its own phi-losophy for the interpretation, place and role of pain. Different cultures strived for mitigating pain in accordance with their traditions. The experience gained in this manner survived for many centuries and thousands of years and was part of the medicine of the given society. Pain has been defined in many ways by many people. Several theories have been developed regarding the origins of pain and even today efforts are being made worldwide to understand it. Numerous scholars’, great thinkers’ and doctors’ names can be found in the historical de-scriptions regarding pain relief, the philosophical approach to pain and the research related to it.

Pain is subjective, it is our own, no one can assess a given experience of pain other than us. Many times we do not un-derstand why being exposed to the same influence causes pain on one occasion and not an unpleasant experience on another. Pain may be triggered by various types of stimuli, e.g. mechanical, chemical or heat exposure. According to one of the most well known definitions, pain is a behavioural response to a potentially tissue damaging stimulus. It is diffi-cult to comprehend why pain is not felt by an injured football player when he is just about to score a goal on the football field, or a fleeing soldier who has been shot, a restaurant cus-tomer having hot fisherman’s soup or a couple being involved in intense love making during a normal sexual intercourse.

Earlier notions about the origin of pain were refuted one by one, it seems that we need to break up with some traditionally perceived as true theories. It is not true that the excitement of nerve endings specialized in pain cause pain, there are no so-called pain receptors. In some cases not only potential but obviously tissue damaging stimuli do not result in any pain, however, intense pain may develop without any damaging stimuli in a physical state characterized by complete peace of mind. The same impact may cause an intense pain experience in the same individual on one occasion while at other times, during a different course of action it may remain unnoticed.

The degree of pain cannot be measured or estimated by an outside observer due to its subjectivity and individual

variabil-ity. According to modern theories, pain becomes conscious in the brain, that is where we are able to locate it, to determine its degree, to store it in our memories and compare it with our prior memories. Subsequent to this one’s pain is reflected in one’s behaviour, mimicry, use of language i.e. in the full range of behavioural response.

The assessment of pain in the world

Pain has been present at all levels in the course of the evo-lution of humanity. Primitive people considered the ordeals that they had suffered from to be of divine origin. The higher level of development characterized in a society, the more people were driven to find rational and scientific explana-tions. The scientific and technological progress has exponen-tially accelerated in the last 150 years, which has led to the development of descriptive sciences, natural sciences, includ-ing medical science. Beinclud-ing in the possession of scientific facts based on sophisticated, reproducible experiments the West-ern civilization could feel entitled to consider the medical sci-ence it had created to be superior. This inevitably meant the rejection of the medicine of Eastern cultures. It is written in the Bible, in the book of Job that pain strengthens the faith towards the Lord. Humility has been a Christian virtue until the present day. Jesus’s suffering and self-sacrifice on the cross meant the end of his earthly existence on the one hand and the indication of the path towards God on the other hand. The few-hundred-year-old scientific results as opposed to the sev-eral-thousand-year-old religious interpretation of pain hardly mean anything to believers. In this way it is difficult to accept the criticism against the traditional 2000 or maybe 4000-year-old Chinese healing art or against the Vedic teachings of India from the part of Western civilization. Pain is an independent entity, no matter whether there is a determining underlying disease or not. The art of Chinese medicine tried to establish the harmony, the balance of the body and the spirit in an ex-pressly practical way. However, technological development arrived in China as well and the traditional healing methods have been replaced by modern Western medical techniques.

Acupuncture had been driven into the background and then revived again. It was exactly the advanced Western technol-ogy, namely the functional magnetic resonance imaging (fMRI) examination that has proved its efficiency. In this way acupuncture is now an accepted method, suitable for therapy and anaesthesia as well in a number of European institutions and pain relieving centres.

15. Pain and Pain Management

by

P

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.D. R

^óbeRt

A

^lmási

, K

^AtAlin

n

^émeth

, K

^AtAlin

F

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Even less is known about the Vedic teachings of India which are believed to date back to a 10,000-year-old history accord-ing to the people of India. The book includaccord-ing teachaccord-ings about health and life is the Ayurveda. Very little information is available on the traditional medicine of India and their effects. They excel mainly in botany, in establishing the balance of body and mind, which is easy to see if we just consider the decoctions, extracts, various types of balm and yoga made in India. There is also an extremely important result concerning the establishment of spiritual balance in terms of pain, e.g. when a fakir endures damage apparently painlessly without a blink of the eye even if physical damage goes as far as self-mutilation.

In other parts of the world where people live in smaller or larger tribal communities, pain is accepted in various ways. The interpretation and value of pain varies due to the religious, ethnic and upbringing differences. The occurrences of diseases with the pain associated with them rise due to the accelerated rhythm of life, the increased life expectancy and getting further away from the Christian religion. The demand for pain relief has grown.

Painlessness is one indicator of health, well-being and coming up to the expectations in one’s work. The right to be relieved of pain and the right to live without suffering are fundamental hu-man rights recognized and accepted all over the world. Unfor-tunately, conditions in many countries of a low social economic level are not favourable in ensuring these basic human rights.

The history of pain and pain management

Pain is as old as mankind is, just as the pursuit to relieve pain.

Conclusions can be drawn about the prehistoric people’s prac-tices to dispel pain based on the ancient and modern written records that we have inherited from tribal peoples. It is assumed that the Palaeolithic people considered pain the punishment of the gods and tried to chase out the evil spirit from the body by making noises, smoking, magic spells and rituals. Making the body rest, being positioned in a peaceful way during the magic spell may really have helped. After a while dancing, singing, the joint chanting of the whole tribe excluded consciousness from the external world along with the pain. The magic spells have been preserved for thousands of years in various forms, which depended on the given cultures and they can be observed in the inherited written records of the Inca and Aztec cultures that still existed a few hundred years ago and in the traditions of today’s ethnic groups and tribes that have survived and still live.

In the course of applying magic spells a new phenomenon ap-peared, namely the first mind-altering plant substances that were thrown into fire and their smoke could be inhaled by the whole tribe. The seeds of a well-known plant, known today as wild hemp from India, were also found near an early Stone Age burial site, used at a ritual fire place. In the Neolithic era, around 3100 BC, writ-ing was invented in Mesopotamia which spread along the rivers to Egypt (Nile), India (Indus) and China (Yellow River).

In the meantime another plant was also grown in Meso-potamia around 3400 BC., which was the joy plant, the hul

In the meantime another plant was also grown in Meso-potamia around 3400 BC., which was the joy plant, the hul

In document Textbook of Nursing Science (Pldal 176-181)