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.
(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
(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.
>= 36 weeks
32 weeks to 35 weeks, 6 days
28 weeks to 31 weeks, 6 days
< 28 weeks
active/awake, eyes open, facial movements
quiet/awake, eyes open, no facial movements
active/sleep, eyes closed, facial movements
quiet/sleep, eyes closed, no facial movements
heart rate, maximum
0-4 beats per minute increase
5-14 beats per minute increase
15-24 beats per minute increase
>= 25 beats per minute increase
oxygen saturation, minimum
0 to 2.4% decrease
2.5 to 4.9% decrease
5.0 to 7.4% decrease
7.5% decrease or more
none (<= 9% of time)
minimum (10-39% of time)
moderate (40-69% of time)
maximum (>= 70% of time)
premature infant pain profile =
= SUM(points for all 7 indicators)
• minimum score: 0
• maximum score: 21
• The higher the score the greater the pain behavior.
To read more or access our algorithms and calculators, please log in or register.