Taddio et al modified the Behavioral Pain Scale (BPS) of Robieux et al for use with infants during office procedures such as immunizations.
The child is evaluated prior to the procedure to give a baseline for comparison during and after the procedure.
(1) facial expression
definite positive expression (smiling)
slightly negative expression (grimace)
definite negative expression (furrowed brow, eyes closed tightly)
laughing or giggling
moaning, quiet vocalizing, gentle or whimpering cry
full lunged cry or sobbing
full lunged cry, more than baseline cry (scored only if child crying at baseline)
usual movements and activity
resting and relaxed
partial movement (squirming, arching, limb tensing, clenching)
attempt to avoid pain by withdrawing the limb where puncture is done
agitation with complex/generalized movements involving the head, torso, or other limbs
after Table 2, page 460
• Slightly negative expressions include brow bulging and naso-labial furrow.
• Definitely negative expressions include brow bulging, naso-labial furrow, eyes closed tight, open lips, with or without a reddened face.
modified behavioral pain scale =
= SUM(points for all 3 parameters)
• minimum score: 0
• maximum score: 10
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