The Numerical Rating Pain Scale

FLACC stands for face, legs, activity, crying and consolability. It is an observer rated pain scale, performed by a healthcare practitioner such as a doctor or a nurse. The FLACC pain scale was designed for children between the ages of 2 and 7. However, some practitioners in adult settings may use the FLACC pain scale for people who are unable to communicate their pain. FLACC provides a pain assessment scale between 0 and 10.

The CRIES Pain Scale is often used in the neonatal healthcare setting. CRIES is an observer-rated pain assessment tool which is performed by a healthcare practitioner such as a nurse or physician. CRIES assesses crying, oxygenation, vital signs, facial expression and sleeplessness. The CRIES Pain Scale is generally used for infants 6 months old and younger.

The cries Pain Scale

The COMFORT Scale is a pain scale that may be used by a healthcare provider when a person cannot describe or rate their pain. Some of the common populations this scale might be used with include:

• children

• cognitively impaired adults

• adults whose cognition is temporarily impaired, by medication or illness

• the learning disabled

• sedated patients in an ICU or operating room setting

The COMFORT Scale provides a pain rating between 9 and 45.

The comfort Scale

The McGill Pain Questionnaire consists of groupings of words that describe pain. The person rating their pain ranks the words in each grouping. Some examples of the words used are tugging, sharp and wretched.

Once the person has rated their pain words, the administrator assigns a numerical score, called the Pain Rating Index.

CONCLUSIONS

Summing up the results of the conducted analysis the following conclusions can be made:

Pain is a sensation that hurts. It may cause discomfort, distress or agony.

Pain may be acute or chronic. Chronic pain is distressing because it affects the sufferer on many levels. Chronic pain may range from mild to severe, and it is present to some degree for long periods of time.

It is important to measure the pain in order to know about it. Pain is difficult to be assessed as it will not be identified by blood tests. It is often difficult to describe pain, because everyone reacts so differently to it.

There are tools for adults and children that are available which can make the person suffering from pain to explain clearly about it. Among them six rating pain scales are the most famous. These are The Wong Baker Faces Pain Scale, The Numerical Rating Pain Scale, The FLACC pain scale, The CRIES Pain Scale, The COMFORT Scale, and The McGill Pain Questionnaire.

BIBLIOGRAPHY

1. dying.about com>…assessingpain.html

2. letstalkpain.com>real story/assessing.html

3. en.wikipedia.org>wiki/Pain assessment

4. apa.org > monitor/2008/05/pain.aspx

5. pain – topics.org > clinical_concepts//assess.php

Annex I

Annex II

McGill Pain Questionnaire

Name

McGill Pain Questionnaire

Synonyms

McGill Pain Index

Source Article

Melzack R, Torgerson WS. On the Language of Pain. Anesthesiology 34: 50-59, 1971

Description

The McGill Pain Questionnaire measures not only its intensity, but also its quality. The questionnaire was developed in 1971 by Ronald Melzack and Warren Torgerson from McGill University in Canada. According to the authors, each disease produces a different quality of pain: causalgia is burning; visceral pain is stabbing or cramping, etc.. Thus, the quality of pain provides a key to diagnosis and may even suggest a course of therapy.

Structure / Content

Sections:

1. What Does Your Pain Feel Like?

2. How Does Your Pain Change with Time?

3. How Strong is Your Pain?

What Does Your Pain Feel Like? Statement: Some of the following words below describe your present pain. Circle ONLY those words that best describe it. Leave out any category that is not suitable. Use only a single word in each appropriate category - the one that applies best.

	Group	Words (points)
1	Temporal	Flickering (1), Pulsing (2), Quivering (3), Throbbing (4), Beating (5), Pounding (5)
2	Spatial	Jumping (1), Flashing (2), Shooting (3)
3	Punctate pressure	Pricking, Boring, Drilling, Stabbing
4	Incisive pressure	Sharp, Cutting, Lacerating
5	Constrictive pressure	Pinching, Pressing, Gnawing, Cramping, Crushing
6	Traction pressure	Tugging, Pulling, Wrenching
7	Termal	Hot, Burning, Scalding, Searing
8	Brightness	Tingling, Itchy, Smarting, Stinging
9	Dullness	Dull, Sore, Hurting, Aching, Heavy
10	Sensory miscellaneous	Tender, Taut (tight), Rasping, Splitting
11	Tension	Tiring, Exhausting
12	Autonomic	Sickening, Suffocating
13	Fear	Fearful, Frightful, Terrifying
14	Punishment	Punishing, Grueling, Cruel, Vicious, Killing
15	Affective-evaluative-sensory: miscellaneous	Wretched, Blinding
16	Evaluative	Annoying, Troublesome, Miserable, Intense, Unbearable
17	Sensory: miscellaneous	Spreading, Radiating, Penetrating, Piercing
18	Sensory: miscellaneous	Tight, Numb, Squeezing, Drawing, Tearing
19	Sensory	Cool, Cold, Freezing
20	Affective-evaluative: miscellaneous	Nagging, Nauseating, Agonizing, Dreadful, Torturing

Pain score = SUM (points for applicable descriptors)

How Does Your Pain Change with Time?

Which word or words would you use to describe the pattern of your pain?

• continuous steady constant 1

• rhythmic periodic intermittent 2

• brief momentary transient 3

Do the following items increase or decrease your pain?

• (1) liquor

• (2) stimulants such as coffee

• (3) eating

• (4) heat

• (5) cold

• (6) damp

• (7) weather changes

• (8) massage or use of a vibrator

• (9) pressure

• (10) no movement

• (11) movement

• (12) sleep or rest

• (13) lying down

• (14) distraction (TV reading etc.)

• (15) urination or defecation

• (16) tension

• (17) bright lights

• (18) loud noises

• (19) going to work

• (20) intercourse

• (21) mild exercise

• (22) fatigue

How Strong is Your Pain?

Statement: People agree that the following 5 words (mild discomforting distressing horrible excruciating) represent pain of increasing intensity. To answer each question below write the number of the most appropriate word in the space beside the question.

Which word describes your pain right now?

• mild 1

• discomforting 2

• distressing 3

• horrible 4

• excruciating 5

Which word describes it at its worst?

• mild 1

• discomforting 2

• distressing 3

• horrible 4

• excruciating 5

Which word describes it when it is least?

• mild 1

• discomforting 2

• distressing 3

• horrible 4

• excruciating 5

Which word describes the worst toothache you ever had?

• mild 1

• discomforting 2

• distressing 3

• horrible 4

• excruciating 5

Which word describes the worst headache yo ever had?

• mild 1

• discomforting 2

• distressing 3

• horrible 4

• excruciating 5

Which word describes the worst stomach-ache you ever had?

• mild 1

• discomforting 2

• distressing 3

• horrible 4

• excruciating 5

Scoring Method / Interpretation

• Minimum pain score: 0 • Maximum pain score: 78 The higher the pain score the greater the pain.