Tenderness is pain or discomfort when an affected area is touched. Whereas pain is the Pt's perception, tenderness is the sign that the clinician elicits.

Sl tender is an abbreviation for slightly tender.

Pain can be graded based upon self-report, observed, or physiological data, depending on age:

• For infants, only observation is available
• For children, self-report using FACES Pain Rating Scale (i.e. series ranging from a happy face at 0, to hurts worst at 10), observation using the FLACC scale (Face Legs Arms Cry Consolability Scale), or physiological data for comfort
• For adults, self-report using Visual analog scale (i.e. psychometric response scale elicited from a questionnaire)

Notable types of pain include:

• Abdominal pain
• Pelvic pain, can be:
  • Bladder (cystitis, bladder stone, bladder cancer)
  • In women, can be uterus, ovaries, fallopian tubes

• Nature and events surrounding the onset, including whether it was gradual, sudden, and trigger/precipitant
• Exact location and radiation
• Severity and character
• Factors to exacerbate or relieve the pain
• Duration, or patterns
• Progression
• Attempts to address the pain, including drugs, allied health (acupuncture, chiropracter, physiotherapy)

• Abdominal pain
• Painkiller
• Neuropathic pain

Paperwork for Acute pain service observation chart includes:

• Affix Pt label
• To be used for - Patient controlled analgesia continuous opioid infusions, Midazolam infusions, Epidural/intrathecal morphine observations
• Under section Modality, ticks for PCA, Continuous Opioid infusions, Midazolam infusion, or Epidural/Intrathecal: Hourly observation until ___. Pain scale is 0 = No pain; 10 = Worst pain imaginable; Omit if Pt asleep. Sedation score is 0=awake, alert; 1=drowsy, easily roused; 2=difficult to rouse; S=asleep, but easy to rouse. Nausea scale is 0=no nausea; 1=nausea only; 2=1-2 vomits -> ensure antiemetics given; 3= >2 vomits/continuous vomiting - RMO review
• Table, which has repeated columns. Rows include Year, Date __/__, Time __:__. Under Pump observations, Total dose in mgs, No of demands, No of "good" injections, Cont inf rate (mLs/hr). Under Pt observations, Pain score (with subdivided cells for 10, 8, 6, 4, 2, 0), Sedation score (with subdivided cells for 0, 1, 2, S), Respirations, Pulse oximetry, Nausea. Final row is Comments, including at the very LHS, Commenced by, and Checked by
• Reverse side is a repeat (dupe)