How to assess pain. Reducing pain is one of the most important things a Paramedic, Nurse or Doctor can do for his or her patient. In order to provide appropriate analgesia and make the patient comfortable, the Paramedic must gauge the patient’s level of pain so that he or she can determine if the treatment is improving the pain or making it worse. There are multiple methods of understanding pain levels, but regardless of which system you use, it is important to understand that it is only a gauge of where the patient’s pain started and whether it is better or worse now. If the patient is in pain he or she needs analgesia –its that simple.
These are the three methods I use for assessing pain:
- If the person is alert and orientated and able to understand the concept, I will ask them: “On a scale of 0-10, where 0 is no pain and 10 is the worst pain you have ever had, what would you rate your pain at now?” Some people will say 10 automatically, this doesn’t mean they’re soft, or that they’re not in pain, or that they’ve never experienced pain before. This is simply a measure of where the pain is going. Therefore, after giving pain relief, ideally the number should come down. If not, you may need to provide more analgesia.
- If the person does not speak a lot of English, or is already disorientated, I will simplify the process a little and ask: is it a little pain, medium pain or big pain. This may also be useful when talking to kids. Then I will ask after providing analgesia: is the pain better, worse or the same?
- Another useful tool that I often utilise while assessing a person’s pain is the OPQRST method of understanding the pain. This includes asking:
O – Onset – When did it start? What were you doing?
P – Provocation – Does anything make it worse? Does anything make it better?
Q – Quality – How would you describe the quality of the pain? Is it sharp, dull, ache?
R – Region – Where does it hurt? Does the pain radiate anywhere else?
S – Severity – How severe is the pain? Here you may use the 0-10 pain score.
T – Time – What is the duration of this pain? When did it start?
4. Don’t forget to look at the patient, look at the position he or she is in, are they guarding anywhere, can they mobilise?