PAIN ASSESSMENT IN CRITICALLY ILL PATIENTS ACROSS LOW-RESOURCE INTENSIVE CARE UNITS; SYSTEMATIC REVIEW.

Abstract

Assessment of pain in critically ill patients (CIPs) in low-resource intensive care units (ICUs) is vital but challenging because of limited infrastructure and training. This review focuses on the epidemiology, causes, necessities, and outcomes of pain assessment in low-resource settings. At rest, pain is experienced in 33-61% of CIPs, of whom 10-33% report moderate to severe pain, with underlying conditions, invasive processes, and psychological variables contributing the strongest considerations. Uncontrolled pain prolongs mechanical ventilation, raises morbidity, and makes it more costly. The gold standard, self-reporting, is not possible due to sedation or ventilation, and it requires validated instruments, such as the Critical Care Pain Observation Tool (CPOT) and Behavioral Pain Scale (BPS). Such cost-efficient instruments have credibility among non-communicative patients and can be applied to low-resource ICUs. Inconsistent practices, cultural barriers, and incomplete documentation, however, impede their application. Educational interventions, including CPOT training and organizational support, enhance compliance. Consistency of pain measurement lowers ventilation time, delirium, and chronic pain, improving living standards. CPOT and BPS, as well as training and policy change, enable low-resource countries to improve patient pain management and outcomes. The review highlights the need for scalable solutions that are accessible to all, providing equitable care in resource-scarce ICUs.