Authorized Agent Controlled Analgesia (AACA)

What is authorized agent-controlled analgesia (AACA)?

AACA is when a family member or a caregiver (authorized agent) gives pain-relieving medicine (analgesic) to a loved one or patient through a device called a patient-controlled analgesia (PCA) pump.

The PCA pump delivers the medicine through an IV tube into one of your veins. AACA is used when a person cannot manage his or her own pain relief. AACA is also used if a person does not understand when and how to give the analgesic.

The authorized agent needs to be approved and trained to administer a person’s analgesia. Only the authorized agent is allowed to dose or give medicine to the patient during a specified time frame.

What is the goal of AACA?

The goals of pain management are:

  • To make a patient as comfortable as possible.
  • To reduce pain without making the person too sleepy.
  • To avoid dangerous side effects of analgesia.

The authorized agent and a health care provider will select a pain scale to use as a marker of the patient’s pain level as well as a comfort goal. The pain scale may be a number scale or a chart with faces that show different levels of pain. If the patient cannot communicate the level of pain, the agent may have to go by the patient’s behavior. Reduced pain—not total relief—is a realistic comfort goal.

How can I tell if my loved one or patient has pain?

A health care provider will teach you to recognize signs of pain. You can also use the pain chart to help the person show you the level of pain that he or she is feeling.

You will also learn how to respond to sudden (acute) pain, such as pain that is caused by changing wound bandages (dressings) or moving into a different position.

What should I do if my loved one or patient has pain?

If the person has pain:

  • Deliver the analgesia dose as instructed by the health care provider.
  • Listen for a tone or a beep from the PCA pump. This sound lets you know that the pump has received the signal to give the analgesia. The analgesia is delivered to the patient through the attached IV tubing.

Try to give doses of the analgesic to the person any time that he or she is in pain and awake. However, the person might not get a dose of analgesic every time that you activate delivery of a dose. This is because the pump is programmed to allow only a specific amount of medicine in a set period of time and to prevent extra doses. This is a safety feature to prevent overdosing.

When should AACA not be given?

  • Do notgive a dose of analgesia if the person is sleeping.
  • Do notgive a dose of analgesia for reasons other than pain relief unless told by a health care provider.
  • Do notgive more pain medicine if the person’s breathing rate has slowed. Analgesia can cause breathing to slow down to a dangerous level (respiratory depression). The patient will need to be monitored for respiratory depression.

What are the risks, complications, and side effects of analgesia use?

The risks, complications, and side effects of using analgesia include:

  • Drowsiness.
  • Sedation.
  • Dizziness.
  • Nausea.
  • Vomiting.
  • Constipation.
  • Slowed breathing.
  • Dependence or addiction. The short-term use of analgesics will be managed carefully to make sure the risk of dependence is as low as possible.

What are the benefits of AACA?

The benefits of AACA are that it:

  • Manages pain effectively.
  • Minimizes the delay in someone getting the pain medicine that he or she needs.
  • Reduces the number of injections for pain relief.
  • Leads to shorter hospital stays. Patients with good pain control get better faster and usually leave the hospital sooner.

When should I seek medical care?

Seek medical care if:

  • There is swelling or leaking at the IV insertion site.
  • The skin near the IV insertion site is cool to the touch.
  • The patient’s pain gets worse or does not get better with the analgesia.
  • The patient:
    • Is dizzy.
    • Is nauseous or vomits.
    • Is constipated.
    • Is no longer in pain but still wants to receive pain medicine.

When should I seek immediate medical care?

Seek immediate medical care if the patient:

  • Is overly drowsy or if he or she fell asleep and cannot be woken up.
  • Is breathing slowly.
  • Is itchy or has a rash.

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