Suominen et al developed the Cardiac Analgesic Assessment Scale (CAAS) for evaluating pain in a child following cardiac surgery. This can help identify patients who may benefit from interventions to address pain. The authors are from University of Melbourne and the Hospital for Children and Adolescents in Helsinki.
Patient selection: child in the pediatric intensive care unit (PICU) who has undergone cardiac surgery
Parameters:
(1) pupillary size in mm
(2) heart rate relative to baseline
(3) mean arterial pressure relative to baseline
(4) respiratory and motor response to repositioning
|
Parameter |
Finding |
Points |
|
pupillary size |
<= 2 mm (pinpoint) |
0 |
|
|
3-4 mm |
1 |
|
|
>= 5 mm |
2 |
|
heart rate |
pacemaker on fixed rate |
1 |
|
|
junctional ectopic tachycardia |
1 |
|
|
within 5% of baseline |
0 |
|
|
1.05 to 1.15 times baseline |
1 |
|
|
> 1.15 times baseline |
2 |
|
mean arterial pressure |
within 5% of baseline |
0 |
|
|
1.05 to 1.15 times baseline |
1 |
|
|
> 1.15 times baseline |
2 |
|
respiratory and motor response |
paralyzed |
1 |
|
|
no response |
0 |
|
|
cough and minimal movement that stops once stimulus removed |
1 |
|
|
cough and/or excessive movement last for more than a minute after the stimulus has stopped |
2 |
where:
• There appears to be assumed that both pupils are comparable in size.
• Baseline heart rate and blood pressure are taken when the patient is at rest and unstimulated.
• Mean arterial pressure = 0.333 ((systolic) + (2 * (diastolic)))
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• A score >= 4 indicates moderate to severe pain is present.
Specialty: Pedatrics
ICD-10: ,
