Critical Care Pain Observation Tool (CPOT)

The Critical Care Pain Observation Tool (CPOT) can be used to evaluate pain in an adult patient in the intensive care unit (ICU).

Parameters:

(1) facial expression

(2) body movements

(3) muscle tension in the upper extremities

(4) vocalization (not intubated) or compliance with ventilator (intubated)

Parameter	Finding	Points
facial expression	relaxed	0
	tense	1
	grimacing (tense muscles plus tightly closed eyelids)	2
body movements	none	0
	protective	1
	restlessness, thrashing, combative	2
muscle tension	none (relaxed)	0
	tense and rigid	1
	very tense and rigid	2
vocalization or compliance	not intubated AND no sound or talking normally	0
	not intubated AND sighing, moaning	1
	not intubated AND crying out, sobbing	2
	intubated AND tolerating ventilator	0
	intubated AND coughing but tolerating	1
	intubated AND fighting ventilator	2

total score =

= SUM(points for all 4 parameters)

Interpretation:

• minimum total score: 0

• maximum total score: 8

• The higher the score the greater the expression of behaviors associated with pain.

Limitations:

• Altered consciousness, paralysis and sedation would mask pain behaviors.

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Purpose: To evaluate pain behaviors shown by an adult patient in the intensive care unit (ICU) using the Critical Care Pain Observation Tool (CPOT) of Gelinas et al.