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Pain scales for self-reporting patients in the intensive care unit (ICU)

Pain scales for self-reporting patients in the intensive care unit (ICU)
Type of instrument Description Comments
Self-report - unidimensional pain, thirst, or dyspnea scale 0 to 10 numeric rating scale (NRS)

Higher numbers indicate greater pain (or dyspnea, or thirst) intensity. Example: 0 = no pain and 10 = worst possible pain. NRS has both construct and concurrent validity.

A 0 to 10 horizontal, visually enlarged laminated NRS for pain is most feasible and valid for ICU patients.
Self-report - unidimensional pain or dyspnea scale 0 to 10 cm visual analog scale (VAS) A 10 cm line, with anchors at either end. Example: one end is marked "no pain" and the other end is marked "pain as bad as it could be" or "the worst imaginable pain." The patient makes a vertical line through the horizontal 10 cm line to indicate his or her pain intensity. The clinician then measures from the left of the horizontal line to the patient's vertical line with a ruler and assigns a score. Difficult for many patients to understand and use.
Self-report - body outline diagram pain scale Identifies pain location. Diagram of front and back of a "neutral" body divided into body sections Patient is able to point to, or mark, the place or places on the diagram where pain is felt. Has been used with ICU patients.
Self-report - multidimensional pain scale McGill Pain Questionnaire-Short Form (MPQ-SF) Scale with 11 sensory (such as sharp or throbbing) and four affective (such as fearful or sickening) words. MPQ-SF also has a VAS and a verbal scale. The 15-word scale has been used in ICU patients.
Self-report - multiple symptoms scale Condensed Form of the Memorial Symptom Assessment Scale (MSAS) Measures a diverse group of symptoms. Has been used with critically ill patients.
Edmonton Symptom Assessment Scale Measures a diverse group of symptoms. Has been used with critically ill patients.
10-item symptom assessment scale Modification of MSAS and Edmonton. Validated in ICU patients.
Reprinted by permission from: Springer: Intensive Care Medicine. Puntillo K, Nelson JE, Weissman D, et al. Palliative care in the ICU: relief of pain, dyspnea, and thirst – A report from the IPAL-ICU Advisory Board. Intensive Care Med 2014; 40:235. Copyright © 2014. https://link.springer.com/journal/134.
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