Pain scale?

[VentMedic]

JCAHO (Joint Commission on Accreditation of Healthcare Organizations) is an accrediting agency that is used by Medicare and several other reimbursement agencies. NO HOSPITAL would ever want an actual Medicare inspection. These hospitals may not be in existence very long if that happens. If a hospital can not pass a JCAHO inspection, then maybe they should collapse or turn their facility over to management that can run a hospital. At least JCAHO has some mercy occasionally and grades on a curve with recommendations if things are just not exactly the way they should be.

Some of the different measures that JCAHO uses are defined in other national standards. JCAHO is only one of many accrediting agencies as each specialty also must undergo their own accreditation process. JCAHO is a kitten compared to some of the other inspections.

Why blame JCAHO for their issues when it comes to patient safety? When hospitals and healthcare providers can not be consistent in patient care or their documentation, then there should be some penalties. Those that don't want to re-educate themselves as times are changing or fail to maintain a safe work environment for their patients are usually the ones that do the most complaining.

 

[enjoynz]

In NZ, on the ambulance they still seem to use the 1 to 10 pain scale.
The hospital's use the Wong-Baker faces.

Cheers Enjoynz

 

[Ridryder911]

Pain control is one of the poorest actions that we in EMS are addressing. So many medics feel that they can determine if a patient is in "true pain" or not. Bull Sh*t!

Health care providers cannot determine such subjective data alone. Kinda like the myth if the patient is sleeping or unconscious they must not be in pain... again B.S. Patients that become so exhausted still have pain, even those in unresponsive state still have nerve responses that are perceived as pain.

Remember, just because it is a 2/10 does not matter. The person's perception of pain varies. I have seen partial amputations with a rating of 5 and the same person screaming of an IV with a rating of 8.

Treat appropriately. They have pain, I assess and use knowledge obtained from history and treat accordingly. Fortunately, my medical director is of age where patients should not hurt. We carry analgesics for that reason !

R/r 911

 

[VentMedic]

But that is the patient's perception of pain. We trend the data we receive from the patient to assess medication titration and treatment plans. Of course, if a Paramedic is only with the patient for 15 minutes, they may not be aware of why the hospital likes to have some information from the patient about pain starting at the onset. If the paramedics themselves have little knowledge in the pain assessment process but rather just ask questions just to be asking them without any consistency, garbage in and garbage out becomes the report we get at the hospital.

It is reinforced many times in the hospital accreditation surveys about the difference between sedation and pain management. So no, JCAHO is not a useless process for the hospitals if more education is encouraged. Now if only the ambulances had some measure to show them where they need more education. Oh wait! They should be doing their own QA and have active medical oversight.

 

[fma08]

http://www.youtube.com/watch?v=UM-HWkbnDfg

About 1:30 the whole pain issue comes up,

(relating to the thread, i use 0-10, 0=none makes sense to me)

 

[Bosco578]

I use the 0-100, yup. Oh your pain is 73.5 / 100..........

Seriously, I use the 0-10 scale.

 

[Airwaygoddess]

Pain scale assessment

0 to 10 is what I was taught.

 

[traumateam1]

I use the 0-10 scale. I haven't actually heard anyone say 1-10 here in BC.

 

[firemedic31075]

Seems to me if your asking your patient how bad their pain is then obviously they must be having pain so it makes sense to use a scale of 1-10. Each time I reassess I ask if they are still having pain and if they are I ask them to rate it. I guess whatever works for you as long as your patient understands it.

 

[VentMedic]

Seems to me if your asking your patient how bad their pain is then obviously they must be having pain so it makes sense to use a scale of 1-10. Each time I reassess I ask if they are still having pain and if they are I ask them to rate it. I guess whatever works for you as long as your patient understands it.

If you are with any hospital affiliated team, Flight, hospital based CCT, ICU, Med-surg or ED, this is a required question or some nonverbal measure of all patients including those that are in a vegetative state, "sedated" and/or on a ventilator. Thus, the 0 - 10 logic for those that can speak or something similar for the nonverbal group. They want no one to feel like their pain, or NOT, was not being addressed. If they state they are having no pain, that is a 0. If all the nonverbal indicators show they are not having pain, that is a 0. Of course, that can be open for interpretation for some patients and is often more difficult to determine unless you are experienced in working with different types of patients.

Just like mentioned earlier;

Pain control is one of the poorest actions that we in EMS are addressing.

 

[reaper]

Unless you are dealing with Pt's like me! I walk around with some kind of pain all the time. Many elderly Pt's are always in some kind of pain, It is just a part of getting older and a side effect of abusing your body when you were younger!