Nonverbal Pain Scale (NVPS) for Nonverbal Patients
Quantifies pain in patients unable to speak (due to intubation, dementia, etc).
INSTRUCTIONS
One can also use the Behavioral Pain Scale (BPS) for Intubated Patients as an alternative to the NVPS.
When to Use
Pearls/Pitfalls
Why Use
No particular expression or smile
0Occasional grimace, tearing, frowning, wrinkled forehead
+1Frequent grimace, tearing, frowning, wrinkled forehead
+2Lying quietly, normal position
0Seeking attention through movement or slow, cautious movement
+1Restless, excessive activity and/or withdrawal reflexes
+2Lying quietly, no positioning of hands over areas of the body
0Splinting areas of the body, tense
+1Rigid, stiff
+2Baseline vital signs unchanged
0Change in SBP>20 mmHg or HR>20 bpm
+1Change in SBP>30 mmHg or HR>25 bpm
+2Baseline RR/SpO₂ synchronous with ventilator
0RR >10 bpm over baseline, 5% decrease SpO₂ or mild ventilator asynchrony
+1RR >20 bpm over baseline, 10% decrease SpO₂ or severe ventilator asynchrony
+2Result:
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