Behavioral Pain Scale (BPS) for Pain Assessment in Intubated 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

Intubated patients, often undergoing painful procedures.

Formula

Pearls / Pitfalls

The Behavioral Pain Scale (BPS) quantifies pain using body language and patient-ventilator interactions for intubated patients. It was developed and validated by performing non-painful procedures (i.e., a central line dressing change) and noxious procedures (i.e., endotracheal tube suctioning) and then observing response patterns.

Critical Actions

The BPS requires attentive clinical observation and examination.

Advice

The BPS is a useful tool to assess pain in intubated patients.

More Information

Score interpretation: Scores ≤3 indicate no pain. Scores 4-5 indicate mild pain. Scores 6-11 indicate an unacceptable amount of pain.* Scores ≥12 indicate maximum pain.* *Note: For scores ≥6 consider sedation and/or analgesia.