Through the years of being an EMT, you generally get a feel for what a patient will state for their pain rating. You know that wonderful 1-10 scale that we have to ask EVERYONE... Well, over time you start to associate certain behaviors with each number. Here is the breakdown I have come up with...
1: Nothing seems out of place. It is almost as if nothing is even wrong. Patient is generally gives this number when they are uncomfortable but feel they should at least give some sort of number. After all, you didn't give them the choice of '0'.
2: This number still has no outward signs of pain in the patient, but they don't want you to think that it is nothing, so they up it just a bit from 1. Think body aches from the flu.
3: This is a number a normal person would just pop a few Advil's for. Think of that nagging headache you get when your inlaws start in on you to produce grandchildren.
4: Here is where you start to see some mild distraction. This number is generally associated with mentrual cramping. (Hey, the masses don't lie!) Most female patients believe this justifies the bitchiest and nastiest responses, because of course they should receive some morphine for the agonizing pain they are suffering from. This is also the number that the tough grandpa Goodcookie's of the world give even if they are having The Grabber. Can't seem like a sissy you know.
5: This number is for those that really have no clue what number to give you. Not horrid like I want to punch someone in the head, but not your run of the mill papercut either. (Maybe a papercut with lemon juice, but still not quite.) You may or may not start to see some grimaces or pauses in sentences when giving their medical history.
6: I like to call this the knuckle stage. When patients reach a 6 they have generally one hand grasping the rail of the cot but still have full useage of the other hand. Of course this also includes the symptoms of #5.
7: Seven is where people start to mean business. This is the pain level that most people need to focus on something to try and distract them from the pain. Whether it be the giant unidentified stain on the ceiling of your ambulance or the mesmorizing rotation of the IV tubing as you roll down the road. When patients start to get that glassy look to them from the sheer concentration of not punching something, they have earned this status. Knuckles on both hands have become white from the judo-death-grip the patient has on both rails of the cot.
8: This number is rarely used by the fakers. I assume that is is getting to that point where eagles fear to fly. It is rough trying to find the most believable rating for their pseudo-symptoms without being obvious. 8 is the start of the "you've got to be kidding me" reactions from preciously mentioned patients. I assume those with obvious deformities to their body parts START at an 8.
9: If someone gives you a rating of 9. They had better be completely pale and vowing they are going to vomit from the pain. Vomiting may or may not commence at this point. Depends on last oral intake. Never have I received a blatant claiming of 9 from the wankers (IE fakers).
10: Vomitting has commenced. Sweating is definitely present. Most identifiable by the long string of words that would make a sailor blush. A simple four letter word is not that uncommon even in the case of sweet old ladies with chains for the eyeglasses and tissues up their sleeves.
There are some out there than can easily trick even the most skilled EMT. The trick to identifying the lying liars is to give a smidgen of pain meds and see how they feel. If they are magically better in a matter of seconds and their pain drops more than 5 points, give them the eyebrow (ala The Rock) 'cause me thinks they are fibbing.
Then again, what do I know. I'm just the "nee-nee" volunteer that is taking care of you.
Next time - Why you should not hit your EMT
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