Definitions
Patient Controlled Analgesia (PCA) is a method of pain control designed to allow the patient to administer pre set doses of an analgesic, on demand (APS, 2003). Although the medications may be delivered via any route, for the purpose of this position statement, the term refers to medications which are administered using an analgesic infusion pump.
Analgesic infusion pump (often referred to as PCA pump) is an electronic micro processing machine which can be programmed to deliver a prescribed amount of medication on demand, at specified intervals, by activation (pressing) of a button. It also has the programming options to deliver patient boluses along with a continuous infusion, or a continuous infusion without patient boluses (thus contradicting the term "PCA" pump.) It can also be used to deliver supplemental clinician "boluses" or "loading" doses of medication.
PCA by Proxy is a term which describes activation of the analgesic infusion pump by anyone other than the patient. The term denotes a variety of practices and has been used to describe both authorized (approved) and unauthorized activation of the device. In this position statement, the term describes unauthorized activation of the pump which the prescriber intended for patient controlled analgesia.
Authorized Agent Controlled Analgesia (AACA) is a method of pain control in which a consistently available and competent individual is authorized by a prescriber and properly educated to activate the dosing button of an analgesic infusion pump when a patient is unable, in response to that patient's pain.
Nurse Controlled Analgesia (NCA): the authorized agent is the nurse responsible for the patient.
Caregiver Controlled Analgesia (CCA): the authorized agent is a nonprofessional individual (e.g. parent, significant other).