Documented Electronic Medical Record-Based Pain Intensity Scores at a Tertiary Pediatric Medical Center: A Cohort Analysis  Jean C. Solodiuk, RN, PhD, Hadley Brighton, BA, MA, Joshua McHale, MPH, Joyce LoChiatto, RN, MSN, Deirdre E. Logan, PhD, Susan Sager, MD, David Zurakowski, PhD, Charles B. Berde, MD, PhD  Journal of Pain and Symptom Management  Volume 48, Issue 5, Pages 924-933 (November 2014) DOI: 10.1016/j.jpainsymman.2014.01.006 Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

Fig. 1 Distribution of pain intensity scores among inpatients 2010–2012. The figure depicts level of pain among inpatients between 2010 and 2012, showing that although most pain scores collected describe a no pain state, roughly 30–33% of pain scores in each year had measurable pain. Journal of Pain and Symptom Management 2014 48, 924-933DOI: (10.1016/j.jpainsymman.2014.01.006) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

Fig. 2 Distribution of pain scores by FLACC and self-report (Wong-Baker Faces Scale and NRS) 2010–2012. The figure suggests a range of pain scores for both FLACC and NRS indicating a higher level of pain intensity with self-reported pain as compared with behavioral assessments of pain. P-value <0.0001. NRS = Numeric Rating Scale; FLACC = Face, Legs, Activity, Cry, and Consolability. Journal of Pain and Symptom Management 2014 48, 924-933DOI: (10.1016/j.jpainsymman.2014.01.006) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

Fig. 3 Pain intensity levels of the highest admitting services by volume. The figure depicts level of pain intensity by admitting service arranged in descending order by admission volume. General surgery and orthopedics have (relatively speaking) a higher percentage of patients with moderate and severe mean pain scores. Journal of Pain and Symptom Management 2014 48, 924-933DOI: (10.1016/j.jpainsymman.2014.01.006) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions

Fig. 4 Mean pain intensity and type of severe pain. The figure outlines the mean level of pain intensity for all pain scores documented during the admission showing that only 1% of admissions had mean scores within the severe range; approximately 9% had mean scores within the moderate-to-severe range; among the 492 admissions with severe pain (scores 7 and greater), approximately 80% involved chronic pain. Journal of Pain and Symptom Management 2014 48, 924-933DOI: (10.1016/j.jpainsymman.2014.01.006) Copyright © 2014 American Academy of Hospice and Palliative Medicine Terms and Conditions