Thursday, May 13, 2004

"The Belle Browne Pain Scale"

© by EBBrowne, R.N. All rights reserved. Please leave copyright intact when sharing the "Belle Browne Pain Scale" with other sufferers. Thank you.

Pain Level Symptoms:

0. No Pain.

1. Slight annoyance, irritation or both; even a slight dull ache. The pain comes and goes, is very mild and slightly effects concentration. Still able to perform all tasks normally and pain is easily forgotten while attending to something else. No pain meds required.

2. Slight pain which lasts a bit longer; still able to perform usual tasks and again, if concentration is shifted away from the pain, the pain is forgotten about. No pain meds required.

3. Pain is more noticeable, twinges come and go. Still able to perform usual tasks, but with a bit of effort. Panadol or Tylenol usually will help with this type of pain.

4. The pain lasts for longer periods, is much more noticeable and is starting to bother and interfere with concentration and tasks requiring more effort and concentration. Panadol or Tylenol taken should alleviate this type of pain; a 4th to 6th hourly regime may be required. A hot pack or ice pack may also help alleviate the pain.

5. The pain is now very noticeable, it is interfering with everyday tasks and a pain reliever is now required at 4 to 6 hourly intervals. Depending on the patient, someone with acute pain may still respond well to Panadol or Tylenol 4th hourly, maybe with added codeine and even heat or ice may help with some relief of this level of pain. For the chronic pain sufferer, this may be the start of breakthrough pain and breakthrough pain meds may start to be thought about, especially if the pain continues to get worse.

6. The pain level is medium.... heading towards strong now and it is becoming more constant and is not easily forgotten about. Pain relief is now required and it may need to be stronger than just Tylenol or Panadol, maybe added codeine may help with level of pain relief...this all depends on whether the pain is acute or chronic and on the patient's actual level of pain tolerance. A chronic pain patient may be still at this level with strong pain relief. Heat or ice may still help lessen the pain.

7. The pain level is now medium to strong and the pain is continuous. It is not relieved by Panadol/Tylenol with codeine, stronger narcotics are required for pain relief. Chronic pain patients may be at this level even with strong narcotic pain relief. Heat may also aid with relief. It is becoming harder to concentrate due to the strength of the pain and its getting harder to relieve the pain.

8. The pain is becoming unbearable, strong narcotic pain relief is required. The chronic and acute pain patient will be irritable, hot and maybe flushed, perspiration maybe noticeable or may not. Blood pressure may also be elevated. Patient may start to shake a bit. If the pain has been going on for too long, then nausea may start to set in and the patient appears to be in a lot of pain and suffering.

9. The pain now is unbearable, only strong narcotic pain relief for the acute patient will help with the pain. The chronic pain patient will be irritable, perhaps flushed and patient's palms are usually sweaty. Blood pressure is usually raised; pain relief needs to be increased and reassessed. Nausea or vomiting may be present. The patient may be trembling or shaking due to the amount of pain, moaning and groaning may be present. Whether the pain is acute or chronic, the patient is usually unable to sleep or concentrate on the smallest task.
10. The pain level is totally unbearable, the patient maybe vomiting or even lose consciousness. The patient may also become delirious, even moaning and groaning without making any sense. The blood pressure may still be elevated or by now may have dropped and the patient may go into shock. The patient must be treated symptomatically...if cold, then the patient should be kept warm; if hot, they should be cooled down. Pain relief is needed urgently. The patient may even become incontinent.

I am usually in the 8-10 scale!