Nonverbal Pain Scale (NVPS) for Nonverbal Patients
Quantifies pain in patients unable to speak (due to intubation, dementia, etc).
One can also use the Behavioral Pain Scale (BPS) for Intubated Patients as an alternative to the NVPS.
When to Use
No particular expression or smile0
Occasional grimace, tearing, frowning, wrinkled forehead+1
Frequent grimace, tearing, frowning, wrinkled forehead+2
Lying quietly, normal position0
Seeking attention through movement or slow, cautious movement+1
Restless, excessive activity and/or withdrawal reflexes+2
Lying quietly, no positioning of hands over areas of the body0
Splinting areas of the body, tense+1
Baseline vital signs unchanged0
Change in SBP>20 mmHg or HR>20 bpm+1
Change in SBP>30 mmHg or HR>25 bpm+2
Baseline RR/SpO₂ synchronous with ventilator0
RR >10 bpm over baseline, 5% decrease SpO₂ or mild ventilator asynchrony+1
RR >20 bpm over baseline, 10% decrease SpO₂ or severe ventilator asynchrony+2
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