Can someone explain the "T" in OLDCARTS pain assessment tool?

Why don't you try using it for Tylenol? How much they have taken and when You know (or will) the extent of tylenol poisoning world wide and what a dangerous drug it is, so much more than opiates, it would be a valid question. It could save their life since people pop it like jellybeans, Then you'd have reason to run a liver panel in due time or stat.

It could also be for travel to any other area of the body indicating nerve involvement. That would not necessarily come out in asking characteristics. Touch might be good indication whether palping a quad affects the pain. The best one would probably be tolerance, indicating just how badly the pain affects doing daily activities. If someone comes in with a complaint that sounds every bit like the appendix during triage, but never make a noise or a face when you really thump hard on the right lower quad, maybe not so fast up to the OR. If they have desperate complaint of pain in a specified area, but they can tolerate picking up their shoes with no sign of discomfort and handling the area gets no reactation and they're cracking jokes with their buddies in the waiting room and things only go south during a physical exam...perhaps truth my work better.?

These are all judgmental evaluations, and you can only go with what you're being told by the patient, to which there can really be no wrong answer, knowing if the TRUTH. dovetails with the complaint ... I wouldn't say they're drug seeking, never, ever, as it has happened too me too many times even with pain doctor appointment business cards and bottles still overflowing with ineffective oxycodone or Dilaudid,(ineffective for that episode at least), but truth should count for much in evaluating pain. But if they come in with LBP and don't make a squeak or squeal as they lean over to toss a piece of rubbish they missed the can with, I would honestly wonder about TRUTH. I would have left the garbage lay where it landed, than bend over with a branding iron going up my spine. I'd apologize for being a lousy shot and messing up the clean floor, but that's the extent of my truth at that moment. You could call it tolerance as well, I guess. Tolerance to movement, tolerance to pain in general.

I was standing at the kitchen sick one day, trying to do my house hold bit by washing some dishes, and had a bad "spike". I could only lay on the floor in a semi fetal position. That went about ten minutes. It took another 10 to crawl to a couch and another couple to figure how to lay down on it without feeling like a speared fish. Had it been at the ER, someone wold have had to come around to my side of the cubbyhole and taken my wallet out for me. No way in hell I was twisting around to get it How many normal life activities can you tolerate?

I don't know if this counts as cheating or not, but a young lady named Suze Randall , a pain physician, wrote an excellent pain evaluation tool. It's not the usual "on a scale of 1-10, 10 being unbearable, etc, etc.". That is so outdated and uninformative both doctor and patient, both walk away feeling like they have wasted a huge amount of time. The doctors have the advantage of knowing they made $400 and patient will unquestionably be back, having done nothing to even assist with a diagnosis. Dr Randall's evaluation sheet has the patient keeping a log of all the questions you have asked plus, a bunch of other questions that lay out a pattern of clues Sherlock Holmes would be envious of. Not sure where in you professional career you are, but we need good understanding doctors in pain medicine that can do the job without fear of patient or the Drug Enforcement Army. Hippocrates was around a lot longer than the DEA. I'm not saying become a pill mill, handing out prescriptions like so much Halloween candy We need strong honest, help from physicians who can separate what they see in TV and movies. Not everyone's answer lies in narcotics, but the public and far too many people with enough degrees they need a second office door for all the initials behind their name, believe whatever non-sense decides spouted from TV or radio. The 5 "w" every journalist (and police investigations) is supposed to use are almost always ignored or left with holes big enough for a cruise ship and all the tugs dragging it around, to get through. With an oil taker or 2 besides. Who What Why Where and When are the facts you're tying to get to in any kind of investigative task. They also throw in How sometimes and an honorary "w".

Sorry I don't know how I got so off topic. It's just when pain is your #1 clue as to what ails a patient,so many physicians refuse to believe it. I wish you luck in your future endeavors whatever they may be