SOCRATES is a mnemonic which can be used by first aiders and healthcare professionals to assess pain. 

Pain is a complex symptom with lots of different dimensions and characteristics. Asking about and documenting a casualty’s pain can provide important clues to the underlying cause of the pain. 

SOCRATES is a good mnemonic for remembering the different questions to ask when presented with a casualty in pain.

In this first aid blog post we’ll go through each component of SOCRATES and provide some example questions which you can ask. 

Site

“where is the pain?” “can you point with one finger where the pain is?”

Establishing the exact site of the pain is important. This can sometimes be difficult! It is important however as “chest pain” or “back pain” are examples of poor pain description as these could mean different things to different people! 

Onset

“when did the pain start?” “did it start suddenly?”

If the pain is intermittent try to establish the time when the pain started for the first time and how often the pain comes and goes.

Character

 “can you describe the pain to me?”

People may use a number of words to describe their pain: Ache, stabbing, sharp, crushing, burning etc.

Radiation

“does the pain move anywhere?”

If the pain is moving to another part of the body, where is this and is it constant?

Associated features

“apart from the pain, have you noticed any other symptoms or problems?”

Are there any associated signs/symptoms e.g. inability to weight bear or vomiting?

Time course

“since your pain started, has it been getting better, worse or staying the same?” 

How does the pain change or not over time? 

Exacerbating or Alleviating Factors

“does anything make the pain better or worse?”

Some pains may be improved or worsened with different positions?

Severity

“on a scale of 0-10 how bad is the pain with 10 being the worst pain imaginable?”

A pain score is intended to judge the severity of the pain that is being experienced. All patients with pain should have a pain score undertaken.

For adults and children who can understand, a simple scoring system is best starting from 0 for no pain to 10 which indicates the worst pain imaginable. The trend in the score is more valuable than the absolute value and the score should be repeated after any treatment.

What is the SOCRATES Acronym?

It is an acronym that stands for site, onset, character, radiation, associations, time course, exacerbating and relieving factors, and severity.

SOCRATES is a mnemonic acronym which is put into use by:

• Nurses
• Physicians
• Emergency medical services
• Other types of healthcare professionals

The purpose of this particular acronym is to determine the kind of pain a patient or victim is experiencing. It helps healthcare providers in evaluating the condition of a patient and create a plan to deal with it in the most effective manner.

The acronym SOCRATES does not focus on the emotional and social effects of pain and chooses to only focus on the physical effects.  

Examples of SOCRATES Questions

Let’s take a look at two scenarios where one can use the SOCRATES acronym:

SOCRATES Questions When Someone Has Chest Pain

• Site: Where exactly are you experiencing the pain?
• Onset: How long did it take for the pain to reach its maximum intensity?
• Character: What is the kind of pain you’re feeling? (Could be crushing, sharp, dull, etc.)
• Radiation: Does the pain travel anywhere else?”
• Associated features: Are there any other symptoms you have developed?
• Time course: How long have you had this chest pain?
• Exacerbating or alleviating factors: Is there anything that reduces the pain or makes it worse?
• Severity: How severe would you say the pain is on a scale of 1 to 10?

SOCRATES Questions When Someone Experiences Shortness of Breath

• Site: NA
• Onset: Did the shortness of breath begin gradually or suddenly? / When did the shortness of breath first begin?
• Character: Can you describe the shortness of breath?
• Radiation: NA
• Associated features: Are there any other symptoms you’re experiencing along with shortness of breath?
• Time course: How has the shortness of breath changed with time?
• Exacerbating or alleviating factors: Is there anything which makes the shortness of breath better or worse?
• Severity: How would you rate the severity of your shortness of breath on a scale of 1 to 10?

Conclusion

The following are the key takeaways from this article:

• SOCRATES is an acronym used by healthcare professionals to understand the kind of pain a person is going through.
• It focuses solely on the physical effects of pain.
• The acronym means site, onset, character, radiation, associated features, time course, exacerbating or alleviating factors, and severity.
• Some of the situations where the acronym can be put to use are when someone has chest pain, and they experience shortness of breath.