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I've found a list of signs they look for that may indicate pain:

1. Vocal complaints: nonverbal
(Sighs, gasps, moans, groans, cries)
2. Facial Grimaces/Winces
(Furrowed brow, narrowed eyes, clenched teeth, tightened lips, jaw drop,
distorted expressions)
3. Bracing
(Clutching or holding onto furniture, equipment, or affected area during
4. Restlessness
(Constant or intermittent shifting of position, rocking, intermittent or
constant hand motions, inability to keep still)
5. Rubbing
(Massaging affected area)
6. Vocal complaints: verbal
(Words expressing discomfort or pain
[e.g., "ouch," "that hurts"]; cursing during movement; exclamations of protest [e.g., "stop," "that's enough"] )

And here is another list: (from all nurses dot com)

1) Facial grimicing- BIG CLUE, you know that little furrow in the brow?
2) Tense body language- If you try to take someone's blood pressure and they are so tense, you can't pull their arm up? Think pain
3) Moaning- BIG CLUE
4) Them saying- "I hurt everywhere" Another big clue.
5) Sleeping all the time. Yes, even if someone sleeps, they could be in pain. I can't STAND when I hear someone say, Well, they were comfortable because they were sleeping. Guess what? I almost slept through the delivery of my son, had him 18 minutes after I got to the hospital, because I slept when I was in labor. When I hurt, I sleep.
6)Combative with care. Think about it. You have someone who is very confused and they are hurting. You are going in to touch them or try to do care. They don't know who you are or what you are doing, all they know is that they hurt and you touching them hurts more. Worse, they can't SAY they hurt because they cannot articulate the sensation with words.
7) Elevated respirations/blood pressure/heart rate ALL indicate pain
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