Pain, The Fifth Vital Sign Got this handout at the Awareness Day rally -- thanks to Jeanne Hess, RN 0 Absence of discomfort 1 Mild pain. Under your conscious radar. Does not interfere with ability to concentrate or perform activities. 2 Discomforting pain. You are periodically aware of discomfort, which subsides with rest, distraction (pleasant activity, music, conversation), change of position, etc. 3 Tolerable, yet annoying pain. NOW is the time to treat with medication in conjunction with comfort measures. Allows best opportunity for effective pain control with the least medication. 4 Pain has your full attention now. "Why didn't I initiate comfort measures and medication sooner?" 5 Moderate pain. Constant, sometimes nauseating pain. Lack of appetite, difficulty concentrating. Begin to isolate self from noise, activity. 6 Grueling, numbing pain. Body tense. Nausea, intolerance for cold, noise and activity increase, mood sinks and increased withdrawal. "Leave me alone." 7 Miserable, agonizing, gnawing pain. "When is SOMETHING going to help?" 8 Horrible, vicious pain. Jaws clenched, respirations rapid & shallow. "WHY isn't anything helping?" 9 Consumed by torturing, crushing unbearable pain. "Get me help NOW!" 10 Physiologically intolerable pain. Loss of consciousness.