ABCDE: Using Mnemonics for Pain Assessment
ABCDE Pain Assessment
Mnemonics can be very helpful in remembering larger bodies of information, and usually if you can remember the first letter, and if the letters in sequence, it makes drawing the information back much more simple.
When we think about pain assessment and management, the Agency for Healthcare Research and Quality has come up with the mnemonic ABCDE to help assess and manage pain. So we’ll go through each letter and tell you what it stands for to help you remember it as well.
So when we think about A under the mnemonic of assessing and managing pain, we need to think of the word Ask. Ask the patient consistently and regularly about their pain. And when doing so, make sure that you keep the same system or scale for them to judge by. If you keep shifting that around, it will be hard for them and for you to understand where they are. So if you say on a scale of 1 to ten, ten being the most pain, 1 being the least pain, don’t then switch it around the next time ad say 1 being the most pain, ten being the least pain, as that confuses the patient, and may confuse you as well. So ask regularly and consistently about where the patient’s pain level is, keep the same scale every time so that you can get the best information from then.
Under B think Believe. Believe the patient’s report of pain. Don’t second guess them, don’t think they’re lying, actually take them at their word. So ask regularly and consistently, and then believe their reported pain, no matter how much pain they’re experiencing, but when they tell you what brought the most relief. So if you’re trying several different ways of relieving the pain, and they happen to key in on one and say I got the most relief from that, believe them. Believe them about the level, believe them about the way they experience the best pain relief.
Under C you need to think of the word Choose. Choose appropriate pain control options according to the needs of the patient, the family, and the setting. So you may have multiple pain control or pain management options, but you want to make sure you choose the best ones for that patient, for that setting, and for that family. So you need to keep all those things in mind. Ask often and regularly, believe the patient, choose the appropriate way of managing the pain from your options based on the patient, the setting, and the family.
And then under D think of the word Deliver. You want to deliver the pain relief in a timely way, a consistent way, and a coordinated way. So timely delivery, consistent delivery, coordinated delivery. But the word once again to remember with D is delivery. Ask regularly and consistently. Believe what the patient says about their pain level and about what best takes away their pain, choose the best option based on out of all the options you have the patient, the setting, and their family. And then deliver in a timely, consistent, and coordinated manner.
And then finally under E think of the word Empower. As much as possible, as much as possible, empower the patient and the family with information that they need and give them as much as possible an active voice in their pain care. Now obviously there are limits on this, but as much as you’re able to empower the patient to drive their pain management. As much as possible, allow them to drive that process. And of course, you empower them once again by asking regularly and consistently, believing them, making the best choice, and then delivering in a timely and consistent way.
I can think of a situation in my own experience where unfortunately the hospital after an open heart surgery did not believe the patient that they were in a great deal of pain, and it turned out that after a full night after the surgery of absolutely zero pain management and excruciating pain, they finally discovered that the pump that was being used to administer the pain relief was not functioning, and so this patient went through hours and hours, an entire evening, with no pain management whatsoever, right after open heart surgery. And we certainly don’t want that to happen. It’s cruel to the patient, it gives the patient a bad reputation.
So if you’ll remember the mnemonic, ABCDE: Ask often and consistently, believe them, choose the best within for the patient, the setting, and the family, deliver regularly, consistently, timely, and then empower the patient as much as possible, listen to their voice. Let them drive their pain management within the boundaries that you have set. So pain assessment and management: ABCDE, pretty easy to remember.