Assessing pain in non-intubated critically ill patients unable to self report: an adaptation of the Behavioral Pain Scale

Abstract

Pain during procedures is perceived even in non-intubated ICU patients with delirium. In those patients, pain level can be assessed with the BPS-NI scale since this instrument exhibited good psychometric properties. Electronic supplementary material The online version of this article (doi:10.1007/s00134-009-1590-5) contains supplementary material, which is available to authorized users.

Evaluating Pain, Sedation, and Delirium in the Neurologically Critically Ill—Feasibility and Reliability of Standardized Tools

“…Pain was evaluated systematically in all patients who were not deeply sedated (Richmond Agitation-Sedation Scale [RASS] S -4). Self-reporting is the most reliable indicator of pain, so numeric rating scales-oral or visual (NRS-0 or NRS-V) were used whenever possible (lO).The behavioral pain scale (BPS) was substituted for intubated patients and its adaptation for the nonintubated patients (BPS nonintubated [BPS-NI]) who were aphasie or otherwise unable to communicate (11,12). The BPS ranges from 3 (no pain behavior) to 12 (maximal possible pain behavior) and was chosen as it avoided using vital signs or other physiological variables that had been previously shown to be less specific in the critically ill ( 13).…”

A Validated Approach to Evaluating Psychometric Properties of Pain Assessment Tools for Use in Nonverbal Critically Ill Adults

“…29 The BPS item "compliance with ventilator" was replaced by "vocalization" in the BPS-NI, which was inspired from the PBAT. 30 The BPS-NI was tested in 30 ICU adult patients with a medical or surgical diagnosis, for a total of 120 paired evaluations.…”

Managing ICU delirium

“…Based on the BPS, Chanques et al [61] developed and validated a modified version of the BPS for non-intubated patients (BPS-NI) with inability to self-report due to delirium in order to improve the measurement of pain. The third domain of the BPS (i.e.…”