HEIT TEMPLATE.PPT 1

The Ten Steps of Universal Precautions in Pain Medicine

1. Diagnosis with appropriate differential2. Psychological assessment including risk of addictive

disorders3. Informed consent (verbal vs written/signed)4. Treatment agreement (verbal vs written/signed)5. Pre/post intervention assessment of pain level and

function

D Gourlay, HA Heit, A AlmahreziUniversal Precautions in Pain Medicine: A Rational Approach to the Treatment of Chronic PainPain Medicine. 2005;6(2):107-12

HEIT TEMPLATE.PPT 2

The Ten Steps of Universal Precautions in Pain Medicine6. Appropriate trial of opioid therapy +/- adjunctive

medication 7. Reassessment of pain score and level of function 8. Regularly assess the “Four A’s” of pain medicine

– Analgesia, Activity, Adverse effects, & Aberrant behavior*

9. Periodically review pain diagnosis and comorbid conditions, including addictive disorders

10. Documentation*Passik SD, Weinreb HJ. Adv Ther. 2000;17(2):70-83

HEIT TEMPLATE.PPT 3

Conclusion

By taking a thorough and respectful approach to patient assessment and management within the context of chronic pain management Stigma can be reduced Overall risk contained Patient care improved

Universal Precautions is not about opioids, it’s about good medical practice