Nonverbal Pain Scale (NVPS) for Nonverbal Patients

Why Use

Nonverbal patients express pain variably, making a standardized, accurate tool helpful in the evaluation of pain. Pain can be a cause of abnormal vital signs in the ICU setting, and using a quantitative tool can help confirm or refute this hypothesis.

When to Use

Patients in critical care settings for whom pain assessment is ongoing.

Formula

Pearls / Pitfalls

The Nonverbal Pain Scale (NVPS) allows for standardized pain assessment in intubated and other nonverbal patients. Parameters include ventilator synchrony, which is helpful in intubated patients.

Advice

Pain can and should be treated, especially in intubated patients or those who are otherwise unable to express their sensorium.

More Information

Score interpretation: Scores ≤2 indicate no pain. Scores 3-6 indicate moderate pain.* Scores ≥7 indicate severe pain.* *Note: Scores ≥3 indicate possible need for analgesia. This assessment is normally documented every 4 hours on nursing flow sheets and completed before and after interventions. Sepsis, hypovolemia, and hypoxia need to be resolved prior to interventions.