Children’s Hospital of Eastern Ontario Pain Scale (CHEOPS) for Post-Op Pediatric Pain
When to Use
Children in the post-operative period.
Formula
Pearls / Pitfalls
Allows for standardized assessment of post-operative pain in children.
Advice
The CHEOPS is widely trusted in post-operative settings.
More Information
Pain assessments should be performed: Every 3 hours 15-20 minutes after IV administration of analgesics 30-45 minutes after oral/rectal administration Scores ≥5: Consider analgesia. Definitions of criteria in the CHEOPS: Criteria Score Definition Cry No cry +1 Child is not crying. Moaning +2 Child is moaning or quietly vocalizing silent cry. Crying +2 Child is crying, but the cry is gentle or whimpering. Scream +3 Child is in a full-lunged cry; sobbing; may be scored with complaint or without complaint. Facial Smiling 0 Score only if definite positive facial expression. Composed +1 Neutral facial expression. Grimace +2 Score only if definite negative facial expression. Child Verbal Positive 0 Child makes any positive statement or talks about others things without complaint. None +1 Child not talking. Other complaints +1 Child complains, but not about pain, e.g., 'I want to see mommy' of 'I am thirsty'. Pain complaints +2 Child complains about pain Both complaints +2 Child complains about pain and about other things, e.g., 'It hurts; I want my mommy'. Torso Neutral +1 Body (not limbs) is at rest; torso is inactive. Shifting +2 Body is in motion in a shifting or serpentine fashion. Tense +2 Body is arched or rigid. Shivering +2 Body is shuddering or shaking involuntarily. Upright +2 Child is in a vertical or upright position. Restrained +2 Body is restrained. Touch Not touching +1 Child is not touching or grabbing at wound. Reach +2 Child is reaching for but not touching wound. Touch +2 Child is gently touching wound or wound area. Grab +2 Child is gently touching wound or wound area. Reastrained +2 Child is grabbing vigorously at wound. Legs Neutral +1 Legs may be in any position but are relaxed; includes gentle swimming or separate-like movements. Squirm/kicking +2 Definitive uneasy or restless movements in the legs and/or striking out with foot or feet. Drawnup/tensed +2 Legs tensed and/or pulled up tightly to body and kept there. Standing +2 Standing, crouching or kneeling. Restrained +2 Child's legs are being held down.