I am looking for a Pain Scale to be used for patients who are unconscious, intubated, or otherwise unable to use the Faces or Numeric Scales. Does anyone out there have a pain scale they use for these patients and can you share it with me?
Sep 10, '02
The only way I know of to try and judge pain in patients who are unconscious or intubated is by change in vital signs. Increases from baseline in heartrate, respiration and blood pressure. If I have pain medication ordered I usually use it especially in my trauma or surgery patients. If the injury looks like it would hurt, it probably does. Sorry I can't be more help.
Sep 10, '02
I am with ptnurse on this one. There is no way to let a person subjectivly rate his pain if unconscious. Maybe if tubed, but the ICU's I worked in kept all tubed patients down with Diprivan, no way for them to let you know either.
I give ordered pain meds on time. I do not think that because they are unconscious they no longer feel pain. Often a tubed person that is sedated using diprivan will break through the sedation if the pain becomes to great, that is why it is important to keep on top of the pain meds for them. If not, you have to bolus the diprivan, and then go about titrating so the pt is a Ramsey 2 again. It is much easier just to give the meds as ordered, on time.
Sep 11, '02
Thank you both for your input, PtNurse and 2ndCareerRN. I guess what we are doing is adequate. I know JCAHO is BIG on Pain Scales and keeping the standard of care consistant throughout the hospital so I wanted to be sure we weren't missing anything.
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