Traumapedia

Pain is a subjective experience, meaning that it is different for different people. This makes the measurement of pain a difficult task. However, pain is an important marker for the presence of, or changes in, a disease. It has even been called the “fifth vital sign” in addition to pulse, blood pressure, respiration, and temperature. Providers use the Visual Analog Scale (VAS) in an attempt to get a standard measure of pain. You may be asked to rate your pain on a 0 (no pain) to 10 (worst pain imaginable) scale in order to measure your current pain level. Although it can be frustrating and difficult to give your pain a number, it is important to get an ongoing assessment of pain from your point of view. This measure will be used over time to look for changes in pain level. It may also help doctors decide whether or not treatments are working.

Example of a Visual Analog Scale

(VAS): No pain 0 1 2 3 4 5 6 7 8 9 10 Worst pain imaginable

The National Comprehensive Cancer Network (NCCN) has representative samples of three types of pain intensity rating scales, including the VAS, at: http://www.nccn.org

A separate scale using facial expressions has proven to be a reliable way for young children to express their level of pain. The hyperlink below will direct you to a web page with a sample of such a visual scale. http://www.cancer.gov/cancertopics/youngpeople/page7.

DEFINITION:

X-rays are a form of electromagnetic radiation, just like visible light. In a health-care setting, x-rays are emitted by a machine as individual "particles" (photons) that pass through the body and then get detected by a sensitive film. Structures that are dense (such as bone) will block most of the photons, and will appear white on developed film. Structures containing air will be black on film, and muscle, fat, and fluid will appear as shades of gray. Metal and contrast media (intravenous or oral contrast) blocks almost all the photons and will appear bright white.

How the test is performed
The test is performed in a hospital radiology department or in the health care provider's office by an x-ray technologist. The positioning of the patient, x-ray machine, and film depends on the type of study and area of interest. Multiple individual views may be requested.

Much like conventional photography, motion causes blurry images on radiographs, and thus, patients may be asked to hold their breath or not move during the brief (approximately 1 second) exposure.

How the test will feel
There is no discomfort from x-ray exposure. Patients may be asked to stay still in awkward positions for a short period of time.

WHAT THE RISKS ARE:

During a single radiograph, a small fraction of the x-rays pass right through the body. The remaining photons are absorbed by tissues in the body. The energy of the absorbed photons can break apart (ionize) compounds, and this may cause cell damage. Most cell damage is soon repaired. However, some is permanent.

For the exposures encountered in conventional radiography, the risk of cancer or heritable defects (due to damaged ovarian cells or sperm cells) is very low. Most experts feel that this low risk is largely outweighed by the benefits of information gained from appropriate imaging. X-rays are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image.

Young children and a developing fetus carried by pregnant women are more sensitive to the risks of x-rays. Women should tell health care providers about suspected pregnancy. Adapted from the National Library of Medicine.