Poker Chip Pain Assessment Tool

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  1. Pediatric Pain Assessment Tools
  2. 4 A's Of Pain Assessment

Inadequate pain assessment in children may lead to an underestimation of pain, and consequently, undertreatment in this population. This article provides an overview of pain assessment and describes specific measurement tools that can be used with infants, children, and adolescents. Poker Chip Tool: assesses pain in children 4 years and up; nurse places red poker chips horizontally in front of the child, with poker chips representing 'pieces of hurt.' ; child selects how many pieces of hurt she/he has: Word-Graphic Rating Scale: assess pain in children ages 4-17 years; uses words on a horizontal linear scale to assess pain. Poker Chip Tool: assesses pain in children 4 years and up; nurse places red poker chips horizontally in front of the child, with poker chips representing 'pieces of hurt.' ; child selects how many pieces of hurt she/he has: Word-Graphic Rating Scale: assess pain in children ages 4-17 years; uses words on a horizontal linear scale to assess pain.

AcronymDefinition
HPCTHigh Performance Cartridge Tape
HPCTHigh Performance Computing Technology
HPCTHigh Performance Computing Toolkit (IBM)
HPCTHampshire Primary Care Trust (UK)
HPCTHematopoietic Progenitor Cell Transplant
HPCTHarrow Primary Care Trust (UK)
HPCTHugh Pilkington Charitable Trust (UK)
HPCTHester Poker Chip Tool (pediatric pain assessment)

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There are several differentpaediatric assessment scales published and available to use. Differentassessment scales are targeted towards different age groups within thepaediatric patient group.

Behaviour ObservationalScales

Observationalassessment scales, where the observer rates a child’s behaviour for indicatorsof pain, are used for children who may not be able to give appropriate verbalresponses. The most commonly used scales for newborn children are the PrematureInfant Pain Profile (PIPP) and CRIES postoperative pain scales (Walker &Arnold, 2009). The FLACC behavioural scale is a behaviour assessment tool whichhas been validated for the use of objectively assessing pain levels in childrenbetween the ages of 2 months and 7 years old (Walker & Arnold, 2009).
Click on the Links below to view an image of the described assessment tools.
PIPPis based on the patients activity, facial expressions andan increase in patients vital sign from baseline recordings to give anindication of an increase in pain scores (Stevens, Johnston, Petryshen & Taddio,1996).

CRIESis a useful tool for neonatal postoperative patients.It assesses Crying, Requirement of oxygen, Increase in vital signs, Expression,and Sleeplessness (Bildner, 1997).

Poker chip pain assessment tool reviews

FLACC is based on the observer’s assessment of the patientsFace, Legs, Activity, Cry and Consolability (Walker & Arnold, 2009).


Self-Reporting Scales

Children from 3 years of agehave the potential to reliably self-report pain using one of a number ofself-reporting pain assessment tools. These tools include the Faces pain scale– Revised, and the Wong-Baker faces pain rating scale. The Oucher scale usesphotographic images of children in differing stages of distress and a scale of0-10 alongside each picture. Younger children may find the poker chip scale usefulto quantify their pain whereas older children may be able to use the visualanalogue scale (Walker & Arnold, 2009).

Tool

Wong-Bakerfaces pain scale uses cartoon faces withdiffering expressions to indicate severity of pain from 0-10 (Walker & Arnold,2009).

The Faces pain scale has been revised from the initial sevenfaces to six with the first face representing no pain, of a 0/10 and the lastface representing 10/10. The revised faces pain scale differs from theWong-Baker faces as the ‘no pain’ face has a neutral expression instead of asmile and the most severe pain face does not have tears (Hicks, von Baeyer,Spafford, van Korlaar & Goodenough, 2001).

The Oucherscale is unique in the fact that it is availableshowing a child of a different sex and race to allow the patient to relate tothe images more easily (Beyer, Villarruel & Denyes, 2009).

Poker Chip scale uses four ‘poker chips’ as ‘pieces of hurt’which the child uses to indicate how much pain they are feeling (Kohntopp,2011).

Visual Analogue Scale consists of a line usually 10cm longwith one end representing no pain and the other end representing severe pain.The patient indicates the level of pain experienced by indicating an area onthe line (Kohntopp, 2011).

There is no consistent evidencesuggesting one assessment tool superior to another, however to maintain a levelof consistency in patient assessment research suggests the same scale should beused throughout an institution (Kohntopp, 2011 & Walker & Arnold, 2009).

Pediatric Pain Assessment Tools

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