How to use OPQRST as an effective patient assessment tool

OPQRST is a useful mnemonic (memory device) used by EMTs, paramedics, as well as nurses, medical assistants and other allied health professionals, for learning about your patient’s pain complaint. It is a conversation starter between you, the investigator, and the patient, your research subject.

Here are some suggestions on how to approach using OPQRST as a patient assessment tool:

• Onset: “Did your pain start suddenly or gradually get worse and worse?” This is also a chance to ask, “What were you doing when the pain started?”
• Provokes or Palliates: Instead of asking, “What provokes your pain?” use real, casual words. Try, “What makes your pain better or worse?”
• Quality: Asking, “Is your pain sharp or dull?” limits your patient to two choices, when their pain might not be either. Instead ask, “What words would you use to describe your pain?” or “What does your pain feel like?”
• Radiates: This is another chance to use real, conversational words during the assessment. Asking, “Does your pain radiate?” sounds silly and pompous to the patient. Instead use this question, “Point to where it hurts the most. Where does your pain go from there?”
• Severity: Remember, pain is subjective and relative to each individual patient you treat. Have an open mind for any response from 0 to 10.
• Time: This is a reference to when the pain started or how long ago it started.

Use OPQRST wisely to get plentiful and useful clues about your patient's pain complaint. Then use the tools, training and protocols available to you to manage the patient's pain.

This is also an opportune time to investigate for associated signs and pertinent negatives.

What are your successful OPQRST tricks? Share them in the comments section.

This article, originally published March 19, 2009, has been updated.