OUCH a new pain scoring system for SortED tablet

The accurate and early evaluation of pain in Emergency Departments is the key to prompt and appropriate analgesia administration.

 

At the time of our first ED trial (July 2016-April 2017), both SortED® and the Imperial College Healthcare NHS Trust’s (ICHT) software used a simple 1-10 ‘pain ladder’ approach to record patients’ description of their pain.

 

The Manchester Triage System implemented at ICHT also uses pain as a so-called ‘discriminator’ to help set the acuity with ‘Moderate pain’ for example, automatically setting the acuity as level 3 (MTS uses 1-5 acuity levels).

 

187/529 patients’ ICHT records (42.2%) were marked ‘Moderate pain’. However 90 of these patients had a pain ladder score of zero and the remainder scores 1 to 10. Clearly nurses had identified a convenient method to arrive at acuity = 3.

 

Users of SortED told us that they found the SortED pain ladder ‘easy to miss’.  Bench tests showed surpirisingly wide variation in how nurses interpreted patients’ descriptions of their pain such as ‘severe’ ‘quite nasty’ etc.

 

OUCH is an acronym for Objective, Unbiased, Cross-checked Help with pain scoring. Today we Skyped with two ED doctors and an ED nurse volunteer about testing a stand-alone OUCH prototype. OUCH uses physical findings and observations as well as the patient’s own description of their pain. These tests will help us perfect the cross-checking algorithm which picks up discrepancies in findings to give a more objective pain score.

 

Gillie Francis – Sep 2017