Pain Assessment ToolsHOW TO TELL THE PAIN “DESCRIBED” BY THE PATIENT

History Taking Character (different types of pain: nociceptive, neuropathic,

visceral) Onset (initiating event, may have medicolegal impact) Location (do not assume: pt may be more bothered by urine

catheter pain than surgical site pain) Duration Factors (relieving, aggravating) Intensity (pain score- to gauge response to treatment) Recurrence (frequency- PRN and/or regular analgesics?) Evolution (course, investigations done, treatments rendered)

Physical Examination General

Mental state Decide history from pt or surrogate, & appropriate pain assessment tool

Vital signs Severe pain can cause hypertension and tachycardia Certain painful conditions can compromise vital signs eg. sepsis from

perforated appendicitis, myocarditis/ AMI Specific

According to location of pain: eg. joint, abdomen, surgical/ trauma site

To rule out other causes: eg. neck stiffness in headache (meningitis), severe abdo pain in a POD3 resection of colon tumor (anastomotic leak)

Pain Assessment Scales used in NUH

Pain Assessment Scales used in NUH