We use the Adapted Mankoski Pain Scale where a 9 in Unable to speak. Crying out or moaning uncontrollably – near delirium. and a 10 is Unconscious. Pain makes you pass out. It's really cute when one of the assistants ask pts. "What is your pain level today?" and when the pt says "9" he says "What, I can't hear you?" and the pt replies "9" and the assistant again says "What, I can't hear you?" and the pt replies "9"... goes on about 3-4 times and then when the assistant shows them the pain scale we use they chose a 4.