Clinical Indications:

 

• Any patient with pain.

 

Definitions:

 

• Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage.
• Pain is subjective (whatever the patient says it is).

 

Procedure:

 

1. Initial and ongoing assessment of pain intensity and character is accomplished through the patient’s self report.
2. Pain should be assessed and documented in the PCR during initial assessment, before starting pain control treatment, and with each set of vitals.
3. Pain should be assessed using the appropriate approved scale.
4. Three pain scales are available: the 0 – 10, the Wong - Baker "faces", and the FLACC.
   1. 0 – 10 Scale: the most familiar scale used by EMS for rating pain with patients. It is primarily for adults and is based on the patient being able to express their perception of the pain as related to numbers. Avoid coaching the patient; simply ask them to rate their pain on a scale from 0 to 10, where 0 is no pain at all and 10 is the worst pain ever.
   2. Wong – Baker “FACES” scale: this scale is primarily for use with pediatrics but may also be used with geriatrics or any patient with a language barrier. The faces correspond to numeric values from 0-10. This scale can be documented with the numeric value.
   3. FLACC scale: this scale has been validated for measuring pain in children with mild to severe cognitve impairment and in pre-verbal children (including infants)

 

 

Certification Requirements:

 

• Maintain knowledge of the indications, contraindications technique, and possible complications of the procedure.  Assessment of this knowledge may be accomplished via quality assurance, mechanisms, classroom, demonstrations, skills stations or other mechanisms as deemed appropriate by medical control.