How to assess pain?

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"On a scale of 1 to 10...", sounds familiar? Have you tried rating your own pain? Curious about how pain is assessed? This video is for you!

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Recap 📝
1. OLDCART can be used to assess pain systematically.
O - Onset, when did the pain first start?
L - Location, where does it hurt?
D - Duration, how often does the pain occur and how long does it last?
C - Characteristics, how does the pain feel like?
A - Aggravating factors, what makes the pain worse for the patient?
R - Relieving factors, what makes the pain better?
T - Treatment, what are the previous and current treatments, and were they effective?

Pain assessment scales (for communicative patients):
1. Numerical rating scale is commonly used for oriented patients who can quantify pain from a scale of 0 to 10, where 0 is no pain, and 10 is the worst possible pain.

2. Descriptive scale is used for patients who cannot quantify pain. Patients are asked to describe the pain on a scale of no pain, mild pain, moderate pain to worst possible pain.

Pain assessment scales (for patients who can't verbalise):
1. Wong-Baker Faces Pain Rating Scale
- Pain is represented using facial expressions, from a scale of 0, meaning no pain😀 to 10 meaning severe pain 😢.

2. Pain Assessment in Advanced Dementia (PAINAD)
- Conducted by a healthcare worker for patients who are unable to communicate in any meaningful way and are not oriented.
- The assessment components are: 1) breathing, 2) presence of groaning, 3) facial expression- is there any facial grimace, 4) body language and 5) the need to be comforted.

References
1. Brant JM. The global experience of cancer pain. Asian Pac J Cancer Prev. 2010;11 Suppl 1:7–12.
2. Gordon DB. Acute pain assessment tools: let us move away beyond simple pain ratings. Curr Opin Anaesthesiol. 2015;28(5):565-569.
3. Welchek CM, Mastrangelo L, Sinatra RS, Martinez R. Qualitative, and quantitative assessment of pain. In Sinatra RS, de Leon-Cassaola OA, editors. Acute pain management. Cambridge: Cambridge University Press; 2009. p.147-171.

Content experts: Dr. Ho Peiyan and Henry Kong
Video producer: Perry Lee
Voiceover: Henry Kong

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