PAIN CHART

BY : ZARINA BT ABD. RAHIM

PAIN CHART??PAIN AS THE FIFTH VITAL SIGN

MUST BE ASSESED EACH TIME VITAL SIGNS ARE PERFORMED

CLIENT SPECIFIC : PAIN IS WHAT PATIENT SAY IT IS

MEASURE ON 0 – 10 SCALE

0 MEANS NO PAIN AND 10 MEANS WORST PAIN EVER.

GOAL FOR PAIN CONTROL IS 2

DOCUMENTATION : ABDOMINAL PAIN 5/10, PATIENT DECLINED MEDICINE.

Pain is called the fifth vital sign, in conjuction with temperature, pulse,

respiration & blood pressure .

Pain can reveal a tremendous amount about the health status of a person.

Pain also affects on such things as mood, activity, appetite, sleep, hygiene and the ability to focus and concentrate.

THE FIFTH VITAL SIGN

PAIN CONTROL

To achieve adequate pain control it is necessary to understand how to

assess pain .

Pain is totally subjective and what causes excruciating pain to one person, may only be perceived as moderate pain to someone else.

ASSESSMENT TOOLS•There are several pain assessment tools

used by health care professional to help assess the pain levels. This include the Wong Baker faces Pain Rating Scale which have several faces from a smiling face (represent no pain) to face with tears and scowl (represent the worst pain

imaginable)

VERBAL PAIN SCALE

A verbal pain scale uses colour from blue to red and a series of vertical lines stretching from blue representing pain, to deep red

representing severe pain .

NUMERICAL PAIN SCALE

Numerical pain scale uses number from 0 to 10 , where 0 represent no pain and

10 represent worst pain imaginable .

In addition to the pain scales, nurses will ask questions to determine the quality of the pain and how its affect patient’s

functioning .

*Where is the pain?

*When did it start?

*What make it worse?

*What helps to ease it?

*Is it sharp, dull, aching, throbbing ,

shooting, burning?

How does the pain affect your life?Sleep patterns

Eating

Activity patterns

Mood and emotions

Does the pain affect patient’s physical appearance / sexual

function / energy levels ?

PAIN MEDICATION

Medication will not cure or eliminate pain

Medications work in many ways to help to ease patient’s pain, by improving patient’s flexibility by treating underlying factors causing the pain, or by reducing inflammation or swelling. Medications help to ease pain by changing how brains

perceives the pain .

Rating scale is recommended for persons age 3 years and older

Brief instructions : Point to each face using the words to describe the pain intensity. Ask the child to choose face that best describes own pain and record the appropriate

number .

FLACC Scale Category Scoring

012

FaceNo particular expression or smile

Occasional grimace or frown, withdrawn, disinterested

Frequent to constant quivering chin, clenched jaw.

LegsNormal position or relaxed

Uneasy, restless, tense Kicking or legs drawn up.

Activity Lying quietly, normal position, moves easily

Squirming, shifting back and forth, tense

Arched, rigid or jerking

CryNo cry ( awake / asleep )

Moans or whimpers; occasional complaint

Crying steadily, scream or sobs, frequent complaints

Consolability Content, relaxed Reassured by occasional touching, hugging or being talked to distractable

Difficult to console

FLACC Rating Scale to be use for children less than 3 years old of age or other patients who cannot self report. Can also be used in cognitively impaired or demented

adults .

Each of the five categories Face, Legs, Activity, Cry and Consolabilityis scored from 0 – 2, resulting in total range of 0 - 10

HOW & WHERE TO CHART?

In nursing report please document the characteristic of pain

ProvokesWhat provokes the pain (exertion, spontaneous onset, stress)

Location Where does it hurt?

Radiation or relief Does it travel anywhere? ( to the jaw, back, arms, etc) what makes it better? ( position / being still ) What make it worse? ( inspiration /

movement? )

Onset When did it start?

Severity or Signs & Symptoms

Are they any associated signs and symptoms? (nausea, anxiety, dizziness, dyspnea, SOB, pallor)

Provide comfort Positioning, rest & relaxation

Validate patients response to pain

Offer reassurance

Relieve anxiety and fears

Set aside time with patient

Relaxation techniques

Rhythmic breathing, guided imaginery

Cutaneous stimulation

Massage, heat & cold therapy

Decrease irritating stimulation

Bright light, noise & temperature.

FACIAL EXPRESSION & CRY

ANY QUESTIONS??