Major Incident Planning and Support (MIP+S) Level 2

80 videos, 4 hours and 32 minutes

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Assessing pain

Video 19 of 80
3 min 5 sec
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Pain is a subjective feeling that people feel. However, as a clinician, you are assessing somebody else's pain, so it then becomes objective. So there are pain tools. There is the pain ladder, there is the pain smiley faces, various different pain tools. Generally, it is accepted that pain is on a scale of 0 to 10, some places do 0 to 3, which is very, very simplified, some people do 0 to 5, but generally, it is 0 to 10. What is probably more important to a triage clinician is what kind of pain, is it sharp or dull? Is it spasmodic? Is it crampy? Does it radiate anywhere? It is more about the quality of the pain than the severity of the pain and in triage, it is usually facilitated that you can give pain for mild to moderate pain in the form of paracetamol or ibuprofen.

You mentioned some of the tools. Can you expand on that a little bit? I know there is a PQRST, could you explain that to me just briefly?

Another mnemonic but it is one that works, PQRST. So P would be provocative and palliative. So what makes it worse? What makes it better? Q is the quality of the pain. What kind of pain is it? Sharp or dull. R is for radiation of pain that somebody may have lower back pain, a problem with the sciatic nerve, which is giving them pain down the leg, S is the severity, so that is the numeric scale, really. And T is timing, so when did the pain start?

I know there is another technique that you quite like, which is the smiley face, the pictures. Can you explain that to us in brief?

Okay, so the smiley faces represent the progression of pain along the numerical scale, 0 to 10, and the smiley faces correspond with different values along the pain scale. So a patient could say, "Well, my pain is 5 out of 10." But they are actually smiling and on the pain scale, you can show the patient, "Well, look, your face does not match the 5 out of 10 face that we have got here for pain, so looking at the smiley faces here, which face do you think represents... " So there is various angles you can come in and you can correspond the face, is somebody crying or are they screaming out in agony? Or are they smiling and joking and laughing?

Was that system originally designed for children, yes but it works with adults.