Description

The Premature Infant Pain Profile (PIPP) is a behavioral measure of pain for premature infants. It was developed at the Universities of Toronto and McGill in Canada.


 

Indicators:

(1) gestational age

(2) behavioral state before painful stimulus

(3) change in heart rate during painful stimulus

(4) change in oxygen saturation during painful stimulus

(5) brow bulge during painful stimulus

(6) eye squeeze during painful stimulus

(7) nasolabial furrow during painful stimulus

 

Scoring instructions:

(1) Score gestational age before examining infant.

(2) Score the behavioral state before the potentially painful event by observing the infant for 15 seconds .

(3) Record the baseline heart rate and oxygen saturation.

(4) Observe the infant for 30 seconds immediately following the painful event. Score physiologic and facial changes seen during this time and record immediately.

Indicator

Finding

Points

gestational age

>= 36 weeks

0

 

32 weeks to 35 weeks, 6 days

1

 

28 weeks to 31 weeks, 6 days

2

 

< 28 weeks

3

behavioral state

active/awake, eyes open, facial movements

0

 

quiet/awake, eyes open, no facial movements

1

 

active/sleep, eyes closed, facial movements

2

 

quiet/sleep, eyes closed, no facial movements

3

heart rate, maximum

0-4 beats per minute increase

0

 

5-14 beats per minute increase

1

 

15-24 beats per minute increase

2

 

>= 25 beats per minute increase

3

oxygen saturation, minimum

0 to 2.4% decrease

0

 

2.5 to 4.9% decrease

1

 

5.0 to 7.4% decrease

2

 

7.5% decrease or more

3

brow bulge

none (<= 9% of time)

0

 

minimum (10-39% of time)

1

 

moderate (40-69% of time)

2

 

maximum (>= 70% of time)

3

eye squeeze

none (<= 9% of time)

0

 

minimum (10-39% of time)

1

 

moderate (40-69% of time)

2

 

maximum (>= 70% of time)

3

nasolabial furrow

none (<= 9% of time)

0

 

minimum (10-39% of time)

1

 

moderate (40-69% of time)

2

 

maximum (>= 70% of time)

3

 

premature infant pain profile =

= SUM(points for all 7 indicators)

 

Interpretation:

• minimum score: 0

• maximum score: 21

• The higher the score the greater the pain behavior.

 


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