There, I said it, now let the collective nursing/medical community rain fire upon me. I'm sorry, but I refuse to accept the idea that pain is a vital sign. I vital sign in a physiological response that is measurable, comparable and deviations represent a serious disruption of homeostasis. Pain is a subjective sensation felt in response to injury. The pain scale we use is useless for traditional "vital sign" purposes. I can't tell you how many times I've triaged a person with 10/10 belly pain while they sit there and eat McDonalds/doritos in front of me. I've never seen a person with a fever of 105, a HR of 180 or a RR of 40 sit there and eat McDonalds. The fact is that pain is far too subjective to be considered a "vital sign". VS are used to assess a patient's physiological condition, and are compared with normal ranges of known, universial numbers. That doesn't mean that pain is not important, because it is a useful tool. The pain scale can be used to asses the efficacy of treatment, but I don't think it's a good indication of homeostatis. For example, I once had a woman who was in a fairly minor car accident and had 4/10 side pain but she said she had a high tollerance for pain. Her spleen was ruptured. Yet our McDonalds friend is still in 10/10 pain. Without a frame of reference, the pain scale tells us little. There are a lot of other things that deserve to be a vital sign before pain does, such as pulseoximetry or blood glucose level. We care if our pt is in pain, but it should not be considered a VS... just my thoughts.
