Hodgkinson et al developed the Pain Assessment Tool (PAT) to measure pain in a neonate. This can be used to monitor postoperative pain and to evaluate the response to inteventions. The authors are from the Royal Children's Hospital in Melbourne, Australia.
Exclusion: paralyzed neonate
Parameters:
(1) posture and tone
(2) sleep pattern
(3) expression
(4) skin color
(5) cry
(6) respirations
(7) heart rate at rest
(8) oxygen saturation
(9) blood pressure
(10) nurse's perception
|
Parameter |
Finding |
Points |
|
posture and tone |
normal |
0 |
|
|
extended |
1 |
|
|
flexed and/or tense |
2 |
|
sleep pattern |
relaxed |
0 |
|
|
withdrawn |
2 |
|
|
agitated, restless, squirming |
|
|
expression |
relaxed |
0 |
|
|
frown (shallow furrows, eyes lightly closed) |
1 |
|
|
grimace (deep furrows, eyes tightly closed, pupils dilated) |
2 |
|
skin color |
pink and well-perfused |
0 |
|
|
pale |
2 |
|
|
dusky or flushed |
2 |
|
cry |
no |
0 |
|
|
loud cry, whimpering, whining, poorly consolable |
2 |
|
respirations |
normal |
0 |
|
|
tachypnea at rest |
1 |
|
|
apnea at rest or with handling |
2 |
|
heart rate at rest |
normal |
0 |
|
|
tachycardia at rest |
1 |
|
|
fluctuating (at rest, spontaneous) |
2 |
|
oxygen saturation |
normal |
0 |
|
|
desaturated with or without handling |
2 |
|
blood pressure at rest |
hypotension |
2 |
|
|
normal |
0 |
|
|
hypertension |
2 |
|
nurse's perception of pain |
no |
0 |
|
|
yes |
2 |
where:
• The extended posture and tone includes widespread digits, rigid trunk, limbs drawn out, and shoulders raised from bed.
• The flexed/tense posture includes clenched fists, trunk guarding, limbs being drawn to midline, and resistance to posturing the head and shoulders.
• An abnormal sleep pattern includes waking with startle, easy waking, eye aversion (shut out).
• I am not sure how objective the nurse perception item is. Including it as integral part of the score may invite bias.
total score =
= SUM(points for all 10 parameters)
Interpretation:
• minimum score: 0
• maximum score: 20
• Levels of pain were (1) > 10 and (2) > 5
Specialty: Pedatrics
ICD-10: ,
