[Yolande Nomdo]

#89758

There are many tools which can be used to measure the pain experienced by a patient.
A variety different tools are available to use in the assessment of a patients physical, psychological and spiritual needs.
The Visual analogue scale (VAS), no pain to worst possible pain.
The Numeric rating scale are common scales used.
These scales are from 0-10,which includes no pain(0), moderate pain(5),and worst possible pain(10).
Another tool for pain assessment in children is Faces Scale for verbal children. It is a common misconceptions that a child cannot explain or discuss their pain. Always ask the child and let the parent or caregiver fill in the details afterwards. When assessing pain in children who are not able to grasp the concept of the visual analogue, faces or numeric scale (pre-verbal or non-verbal), we can use the FLACC scale. Assess the Face,is there no particular expression or smile, occasional grimace of grown or frequent to constant clenched frown.
Legs- is it normal position or relaxed, uneasy, restless or tense, kicking or legs drawn up.
Activity- lying quietly,normal position or moves easily, squirming, shifting back and forth , arched, rigid or jerking.
Cry- no cry(awake or asleep), moans or whimpers occasional complaint,crying steadily, screams, sobs, frequent complaints.
Consolability- content relaxed, no need to console, reassured by occasional touching,hugging or talking to , difficult to console.
Another useful tool in children is the Eland body tool which we use in our workplace. Challenges we faced is that children are not being assessed daily or on a regular basis. Not all children can provide clinicians with a history of pain.
More challenges to be faced
1) cultural barriers
2) gender barriers
3) language barriers and
4) under- or over reporting
5) child with cerebral palsy.
If we cannot assess pain, we will not be able to treat pain.
Pain is complex and pain associated with a life limiting illness is further complicated with all the losses,fears and anxieties associated with death. To assess pain in palliative care is an unfathomable task, however to gain understanding of a patients experience can guide us to develop an individualized care plan for the patient and the family.

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