Pain Assessment Tools

Neonatal/Infant Pain Scale (NIPS)

(Recommended for children less than 1 year old) - A score greater than 3 indicates pain

 

Pain Assessment

Score

Facial Expression

 

 

0 Ð Relaxed muscles

Restful face, neutral expression

 

1 Ð Grimace

Tight facial muscles; furrowed brow, chin, jaw, (negative facial expression Ð nose, mouth and brow)

 

Cry

 

 

0 Ð No Cry

Quiet, not crying

 

1 Ð Whimper

Mild moaning, intermittent

 

2 Ð Vigorous Cry

Loud scream; rising, shrill, continuous (Note: Silent cry may be scored if baby is intubated as evidenced by obvious mouth and facial movement.

 

Breathing Patterns

 

 

0 Ð Relaxed

Usual pattern for this infant

 

1 Ð Change in Breathing

Indrawing, irregular, faster than usual; gagging; breath holding

 

Arms

 

 

0 Ð Relaxed/Restrained

No muscular rigidity; occasional random movements of arms

 

1 Ð Flexed/Extended

Tense, straight legs; rigid and/or rapid extension, flexion

 

Legs

 

 

0 Ð Relaxed/Restrained

No muscular rigidity; occasional random leg movement

 

1 Ð Flexed/Extended

Tense, straight legs; rigid and/or rapid extension, flexion

 

State of Arousal

 

 

0 Ð Sleeping/Awake

Quiet, peaceful sleeping or alert random leg movement

 

1 Ð Fussy

Alert, restless, and thrashing

 

 



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Pages created and maintained by Sara Faulds and James Moore, MD
Last Updated:  September 4, 2007