0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Invited Critique |

Misinterpretation of the Fifth Vital Sign—Invited Critique

Edward H. Livingston, MD
Arch Surg. 2007;142(5):419-420. doi:10.1001/archsurg.142.5.419.
Text Size: A A A
Published online

Extract

Emphasis on pain as the fifth vital sign has become the latest fad in medicine receiving undue attention among regulators and health care commentators. Kozol and Voytovich strike at the heart of this issue with a clear description regarding the differences between pain and other physiologic processes. As Kozol and Voytovich point out, pain is not a vital sign despite the popular new jargon; they elegantly describe the vital signs and how they are measured. Early in medical school, we are taught that signs are physiological processes that can be observed and measured. Symptoms are patients' subjective description of their disease state. Pain is a symptom and not a sign. As such, measurement tools will always fall short in precision and accuracy for pain assessment. Promoting pain as a measurable sign leads to misuse of pain measurement tools, overadministration of pain medication, and a rise in complications attributable to pain management.

Topics

vital signs

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 3

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

The Rational Clinical Examination
Postural Vital Signs

The Rational Clinical Examination
Vital Signs

brightcove.createExperiences();