Healthcare Pain Assessment

Healthcare Pain Assessment

Although the concept of pain has been debated throughout medical history, the current approach to pain is “pain is what the patient reports.” In order to accurately document such a subjective factor, a pain scale is implemented. The average healthcare pain scale will include a range of numbers between 0 and 10. Generally, the healthcare practitioner will use a phrase such as, “If 0 is no pain and 10 is the worst possible pain, what is your pain level?” This is known as the verbal pain assessment. This open ended phrasing allows the patient to better express their pain. However, it is important to note that scales such as this can be biased based on the pain tolerance and past experiences of the individual. 

In some cases, it is not advisable to use a verbal 0 to 10 approach. When assessing the pain level of an individual who is unable to respond accurately, other tools need to be implemented. Cases such as these occur when assessing the pain of infants, young children or individuals who are unable to cognitively understand the verbal scale. Luckily for healthcare providers, several other options are available.

One of the most widely used pain assessments is the Wong Baker FACES® Pain Rating Scale. This uses six simply drawn faces to depict different levels of pain from 0 to 10. The scale begins with a picture of a smiling face, and ends with a picture of a crying face; with increasing levels of discomfort on the faces in between. This scale is commonly used for young children that cannot verbally rate their pain accurately. In this instance, a variation of the phrase, “Which face shows the pain that you are feeling?” is used.

In a more complicated scenario, a Face, Legs, Activity, Cry, Consolability (FLACC) scale can be implemented. This scale is often used with infants and cognitively delayed individuals. This scale involves no direct input from the patient but instead uses a scoring system based on each of the five factors listed above. The practitioner will use observation to score each subsection and calculate the official FLACC score.

The practice of pain assessment is continuously evolving in healthcare. But the current assessment tools give healthcare providers a more accurate representation of each patient’s pain symptoms.