Pain Management

Pain Management at BMH is incorporated into the provision of patient care. Patients are evaluated for potential and actual presence of pain; an initial pain assessment utilizing observation and self-reports of pain is performed; the patient helps develop the management plan including use of prescribed medications and/or non-pharmacologic measures, all individualized for each patient and situation.

The patient’s pain level is reassessed at regular intervals, and documentation is made. Pain management technology such as patient controlled analgesia and surgical site pain pumps is available, as determined by the physician. BMH patient care teams, including medical staff, surgical staff, anesthesiology, oncology, nursing, and others continually research and review new methods of pain management for our patients.

Pain Information

WHAT ABOUT PAIN?

  • Pain is when you have feelings of hurt.
  • It can range from dull aches to sharp, stabbing sensations.
  • Pain can have a serious impact on your quality of living.
  • Pain can change your mood, cause you to lose sleep, and interfere with your daily life.

Make sure that a member of your health team is aware of any pain you are having. Some patients are hesitant to talk about their pain, but we want you to do so.

Tell us the following things about your pain:

  • Where is it located?
  • How bad is it? (See samples of pain scales)
  • What has helped so far or in the past?

If pain medicines are given to you, please:

  • Make sure you know who and when to call if your pain is not well controlled.
  • Learn the possible side effects.

Please also let us know your fears about taking pain medication.

Ask your doctor, nurse, or therapist for more specific information about pain and other methods of pain control.

You have the right to good pain management. At BMH we are committed to treating your pain.

Pain is when your child has feelings of hurt. Pain can have a serious impact on a child’s life. It can change their mood, cause them to lose sleep, and interfere with daily activities. Your child has the right to good pain management.

Tell us about your child’s pain so that we can help him/her get the best relief.

Make sure that a member of your health team is aware of any pain your child is having. Some patients are hesitant to talk about their pain, but we want you and your child to do so.

  • Tell us the following things about your child’s pain:
  • Where is it located?
  • How bad is it? (See below for samples of pain scales)
  • What has helped so far or in the past?

If pain medicines are given to your child, please:

  • Make sure you know who and when to call if your child’s pain is not well controlled.
  • Learn the possible side effects.

Please ask your doctor, nurse, or therapist for more specific information about pain and other methods of pain control. We are committed to treating your child’s pain. Please also let us know your fears about pain medication

(Adapted from University of Michigan Medical Center)

PAIN RATING SCALES: EXAMPLES

For patients who are able to provide a self-report of pain, the three most commonly used pain-rating scares are probably:

1. Numerical or adaptation of visual analog scale (VAS) (e.g., 0-5, 0-10, 0-100)
2. Descriptive or word descriptors (e.g., none, mild, moderate, severe, very severe.
3. Faces (e.g., Wong-Baker)

The above may be combined (e.g., numbers and words; faces and numbers). They may be presented vertically or horizontally. Based on pilot studies of children, it seems that a vertical presentation of words or numbers, such as the vertical line shown on the right, is more easily and quickly understood by the majority of children and adults encountered in busy, stressful clinical settings.

Recommended for persons age three years and older. Explain to the person that each face is for a person who feels happy because he or she has no pain (hurt), or sad because he or she has some or a lot of pain. Face 0 = very happy because he doesn’t hurt at all. Face 1 = hurts just a little bit. Face 2 = hurts a little more. Face 3 = hurts even more. Face 4 = hurts a whole lot. Face 5 = hurts as much as you can imagine, although you don’t have to be crying to feel this bad. Ask the person to choose the face that best describes how he or she is feeling.*

 

*Source: Wong, DL: Whaley and Wong’s Nursing Care of Infants and Children, 5th Edition, Mosby- Year Book, Inc., © 1995.
Source: Margo McCaffery, RN, MS, FAAN, Nursing Consultant, Pain, Los Angeles, California

Infants do have feelings of hurt. They cannot tell us about the pain with words. Instead, they will tell us with signals:

What are the signals that my baby hurts?

Crying is the signal most babies make when they are uncomfortable. It could mean hunger, gas, or a hurt. When a baby is hurting, they often do more than just cry. Look for:

  • Making a face, open mouth, wrinkling their brow, deep lines around the nose.
  • Body changes like stiffening of arms or legs, or going limp.
  • Restless, can’t sleep, or being very quiet.
  • Cannot calm baby with loving, feeding, or changing.

Premature or very sick babies may not have the energy to cry or move when they hurt. The nurses and doctors will watch your baby very closely for signs of hurt.

There are many ways to help babies feel comfort. Please ask the doctor or nurse for more information. We are committed to treating your baby’s pain.

Adapted from University of Michigan Medical Center
BMH Pain Committee
Patient Family Education Council