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The Joint Commission began setting standards for pain assessment in 2001 stating that the route of analgesic administration dictates the times for pain reassessment, as different routes require different amounts of time for the medication to have a therapeutic effect. Oral: 45–69 minutes. Intramuscular: 30 minutes.
Pain is no longer being identified as the fifth vital sign due to the prevalence of opioid abuse and overprescribing of narcotic pain relievers. However, assessment for pain is still very important. Assessment of a patient's experience of pain is a crucial component in providing effective pain management.
Where is the pain? Or the maximal site of the pain. O Onset When did the pain start, and was it sudden or gradual? Include also whether it is progressive or regressive. C Character What is the pain like? An ache? Stabbing? R Radiation: Does the pain radiate anywhere? A Associations Any other signs or symptoms associated with the pain? T Time course
A patient's self-reported pain is so critical in the pain assessment method that it has been described as the "most valid measure" of pain. [ 2 ] [ 3 ] The focus on patient report of pain is an essential aspect of any pain scale, but there are additional features that should be included in a pain scale.
Central stimuli should always be used when attempting to assess if the patient is localising to pain (i.e. moving their arms to the site where the pain is being applied), [3] however it has been suggested that central stimuli are less suitable for the assessment of eye opening, compared to peripheral stimuli, as they can cause grimacing. [4]
This may also be assessed for pain now, compared to pain at time of onset, or pain on movement. There are alternative assessment methods for pain, which can be used where a patient is unable to vocalise a score. One such method is the Wong-Baker faces pain scale. Time (history)
Acute pain indicates assessment, treatment, and prevention are needed. While a child is experiencing pain, physiological consequences can jeopardize healing and recovery. Unrelieved pain can cause alkalosis and hypoxemia that result from rapid, shallow breathing. This shallow breathing can lead to fluid in the lungs, restricting coughing ability.
Following the chief complaint in medical history taking, a history of the present illness (abbreviated HPI) [1] (termed history of presenting complaint (HPC) in the UK) refers to a detailed interview prompted by the chief complaint or presenting symptom (for example, pain).