Frequently Asked Questions

PainTrace® is a pain biosignal that in conjunction with veterinary, or healthcare diagnosis, aids in the identification and measurement of pain. The PainTrace® device is able to interpret the electrical signals produced by nerves through the afferent and efferent pathways, transmit this data via Bluetooth and quantify pain level in real-time graph format of PainTrace® VS Time. 

Depending on the species the calibration peaks may not be as distinct. The key is to monitor baseline collection of data. PainTrace data is being collected, if the following is true:

• Location of sensors is correct. 
• All attachment sites are connected (Sensor Cable to Device, Lead to Sensor, and Sensor to Skin).
• The baseline is not collecting linearly around zero (as demonstrated by disconnecting one sensor lead during training).
• Ensure baseline is stabilized (not sloping) for 30s before starting exam.

NOTE: Sometimes a baseline may fluctuate and have a slight incline or decline, if this is the case proceed with your PainTrace and exam.

Depending on the species the calibration peaks may not be as distinct. The key is to monitor baseline collection of data. PainTrace data is being collected, if the following is true:

• Location of sensors is correct. 
• All attachment sites are connected (Sensor Cable to Device, Lead to Sensor, and Sensor to Skin).
• The baseline is not collecting linearly around zero (as demonstrated by disconnecting one sensor lead during training).
• Ensure baseline is stabilized (not sloping) for 30s before starting exam.

NOTE: Sometimes a baseline may fluctuate and have a slight incline or decline, if this is the case proceed with your PainTrace and exam.

• Baseline trending of data is associated with chronic pain.
• Positive baseline is related to good health. The more positive the baseline, the overall general good health.
• Negative baseline is related to chronic pain. A more negative baseline is associated with increase in chronic pain.
• An increasing baseline may be related to good health, excitement, or anxiety.
• Decreasing baseline denotes an increase in chronic pain.

Negative PainTrace® peaks are associated with acute pain, the larger and sharper the more acutely painful the experience.

Types:

• 1. Intense, sharp, shooting pain = high frequency / narrow negative peak.
  2. Dull, sustained pain = low frequency / lower slope /broader negative change of the baseline.

Ensure that the red lead is attached to the right hand side of the patient and the left lead to the left hand side of the patient. If this is true, and you are still noticing positive peaks, it may be due to the following: 

1. A positive peak may reflect the patient’s feelings of anticipation, excitement or anxiety. From research we have noticed a correlation between positive peaks during activities that may cause a patient to be anxious or excited or be anticipating pain when performing the activity. If the patient is used to the action causing pain when not on drugs, this is where positive peaks may be related to anticipation / anxiety. 

2. Because drugs have an effect on the pain a patient feels, this may affect the PainTrace® signal.

   Drugs that are used to alleviate pain may reduce or eliminate the pain experienced by the patient and therefore reduce or eliminate the pain peak observed during the PainTrace®.

   Neuropathic drugs may cause an inversion of the pain signals. Negative pain peaks may be observed as positive. Because PainTrace® reads the afferent and efferent neurosignals in the body, drugs that affect the patient neuropathically will also have an affect on the signal. Through research we have observed this occurring when a patient is on Gabapentin.

   Also, NMDA antagonist drugs (ketamine & amantadine) are known for blocking the NMDA receptor which is responsible for the transfer of electrical signals between neurons in the brain.

Flat Line Example:

This may be due to attachment of the sensor cable to the device and / or leads to sensors. Please see the options below and their corresponding steps:

1. The sensor cable was not clicked into place to the connector on the device:

   1. Stop trace.

   2. Click sensor cable into place.

   3. Start new trace.

2. The lead(s) were not attached to the sensor(s) on the patient’s skin.

   1. Stop trace.

   2. Attach lead(s) to the correct sensor. Ensure there is metal on metal contact. RED lead attaches to the right sensor.

   3. Start new trace.

3. The sensors are not securely adhered to the patient’s skin and / or there is a pocket created by hair, sweat, water, or air.

   1. Stop trace.

   2. Ensure that the hair is cleanly shaved in the species specific location.

   3. Clean thoroughly.

      1. Pressure should be applied while cleaning the skin with alcohol to thoroughly remove any oils, debris, dirt, hair, sweat & water must be removed from the skin prior to applying the sensors.

      2. Repeat cleaning with a new alcohol pad or gauze until it is visually clean upon final skin wipes. 

      3. Ensure the skin is dry and not wet from water or sweat before adhering the sensors. Use sterile medical gauze to assist with drying as cloth may leave debris.

   4. Place new sensors on completely shaven, clean, dry skin.

      1. Ensure the adhesive ring has good contact.

      2. Press firmly on the metal sensor.

   5. Ensure sensors are flat against the skin and skin is flat to the body. If the sensors are lifting due to sweat or weather conditions, try the following solution:

      SkinTac:

      1. Use the peg to cover the area of skin where the metal sensor will be placed.

      2. Carefully apply one thin layer to the shaved area of skin around the peg.

      3. Hold peg in place until the SkinTac is dry, 15 – 30s, it will be tacky to the touch.

   6. Start new trace.

Sometimes the PainTrace® value starts more negative or positive than the steady state PainTrace® baseline noted as the physiologic baseline. If the baseline is noted to never stabilize and instead slopes up or down, this suggests the sensors are polarized. The sensor calibration peaks will also appear abnormal as described below.

Sensors become polarized due to the interaction of free electrons on the skin’s surface which can impact the PainTrace® signal. If sensors appear to be polarized, this should be resolved before starting the exam.

We advise the following:

NOTE: Do not press too firmly and overshoot the baseline too far. A stable baseline indicates the physiologic baseline has been reached.)

Left if Low – pressing the left sensor will drive baseline down.

• • Sloping up:
    1. Press the right sensor sharply, the baseline will increase.
    2. Wait to see if the baseline becomes stable.
    3. If the baseline continues to increase, repeat 1) to 2)… this speeds up escalation to a more positive baseline equilibrium.

• • Sloping down:
    1. Press the left sensor sharply, the baseline will decrease.
    2. Wait to see if the baseline becomes stable.
    3. If the baseline continues to decrease, repeat 1) to 2)… this speeds up escalation to a more negative baseline equilibrium.

If the physiologic baseline is not reached complete the following:

• • Stop the PainTrace®.
  • Unclip / unsnap sensor leads.
  • Remove and dispose of sensors.
  • Re-clean skin with alcohol and allow to dry.
  • Apply new sensors.
  • Reconnect leads, RED is right.
  • Start a new PainTrace®.

Based on our research, when IV fluids are administered this has not been detected to have any influence on the signal.

NOTE: If there was an extreme change in fluids that might induce nausea or discomfort it is likely PainTrace would be influenced in this case.