| ARCHETYPE ID | openEHR-EHR-OBSERVATION.critical_pain_observation_tool.v0 |
|---|---|
| Concept | Critical care pain observation tool (CPOT) |
| Description | A pain scale for uncommunicative and sedated intensive care unit (ICU) patients based on clinical observation. |
| Use | The scale consists of four behavioral parameters: facial expression, body movements, muscle tension and compliance with the ventilation for intubated patients or vocalization for extubated patients. Patient’s behavior for each of the parameters is scored between 0 and 2. Possible total score ranges from 0 (no pain) to 8 (maximum pain). |
| Misuse | Not to be used outside the scope of uncommunicative or sedated intesive care patients. |
| Purpose | A pain assessment scale for uncommunicative and sedated intensive care unit (ICU) patients based on clinical observation. |
| References | Payen JF, Bru O, Bosson JL, Lagrasta A, Novel E, Deschaux I, Lavagne P, Jacquot C. Assessing pain in critically ill sedated patients by using a behavioral pain scale. Crit Care Med 2001;29:2258-63. Gélinas C, Fillion L, Puntillo KA, Viens C, Fortier M. Validation of the critical-care pain observation tool in adult patients. Am J Crit Care 2006;15:420-7. Pudas-Tähkä SM, Axelin A, Aantaa R, Lund V, Salanterä S. Pain assessment tools for unconscious or sedated intensive care patients: a systematic review. J Adv Nurs. 2009 May;65(5):946-56. |
| Copyright | © openEHR Foundation |
| Authors | Author name: Alan D. March Organisation: Hospital Universitario Austral, Pilar, Buenos Aires, Argentina Email: alandmarch@gmail.com Date originally authored: 2016-07-21 |
| Other Details Language | Author name: Alan D. March Organisation: Hospital Universitario Austral, Pilar, Buenos Aires, Argentina Email: alandmarch@gmail.com Date originally authored: 2016-07-21 |
| Other Details (Language Independent) |
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| Keywords | pain, score, facial expression, body movements, muscle tension, ventilation, intubation, vocalization |
| Lifecycle | in_development |
| UID | 32381533-91bf-45ce-b2f9-49645f4b5cb4 |
| Language used | en |
| Citeable Identifier | 1246.145.2581 |
| Revision Number | 0.0.1-alpha |
| protocol | |
| Extension | Extension: Additional information required to capture local context or to align with other reference models/formalisms. For example: Local hospital departmental infomation or additional metadata to align with FHIR or CIMI equivalents. Include: All not explicitly excluded archetypes |
| state | |
| Intubated? | Intubated?: True if the patient is intubated. |
| Confounding factors | Confounding factors: Any incidental factors related to the state of the subject which may affect clinical interpretation of the measurement. For example, delirium is a common complication in ICU and may affect measurement values. |
| data | |
| Ventilator compliance | Ventilator compliance: Used in mechanically ventilated patients. Please note: for non-ventilated patients, the Vocalization parameter must be used. 0: Tolerating ventilator or movement [Alarms not activated, easy ventilation.] 1: Coughing but tolerating [Alarms stop spontaneously.] 2: Fighting ventilator [Asynchrony: blocking ventilation, alarms frequently activated.] |
| Vocalization | Vocalization: Used in non-ventilated patients. Please note: for mechanically ventilated patients, the Ventilator compliance parameter must be used. 0: Talking in normal tone or no sound [Talking in normal tone or no sound.] 1: Sighing, moaning [Sighing, moaning.] 2: Crying out, sobbing [Crying out, sobbing.] |
| Facial expression | Facial expression: The state and changes in the patient's facial gestures. Facial expression is one of the best behavioral indicators for pain assessment. 0: Relaxed, neutral [No muscular tension observed.] 1: Tense [Presence of frowning, brow lowering, orbit tightening, and levator contraction.] 2: Grimacing [All of the above facial movements plus eyelid tightly closed.] |
| Body movements | Body movements: The patient's pattern of movements. Body movements are the less specific behaviors in relation with pain but may convey important insight. 0: Absence of movements [Does not move at all (does not necessarily mean absence of pain).] 1: Protection [Slow, cautious movements, touching or rubbing the pain site, seeking attention through movements.] 2: Restlessness [Pulling tube, attempting to sit up, moving limbs/thrashing, not following commands, striking at staff, trying to climb out of bed.] |
| Muscle tension | Muscle tension: Generally evaluated by performing a passive flexion and extension of the patient’s arm. 0: Relaxed [No resistance to passive movements.] 1: Tense, rigid [Resistance to passive movements.] 2: Very tense or rigid [Strong resistance to passive movements, inability to complete them.] |
| Total score | Total score: The value which results from adding up the four variables measured. While there are five ordinal data elements represented in this archetype, only one result from either 'Ventilator compliance' or 'Vocalization' may be used to calculate the total score. min: >=0; max: <=8 |
| Comment | Comment: Additional information regarding pain which were not captured by the structured variables but which might be of interest in the individual patient's assessment. |
| events | |
| Any event | Any event: Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time. |
| Other contributors | |
| Translators |