Pain is a common consequence of traumatic brain injury (
), but many TBI patients are unable to communicate their pain. Over time,
untreated pain can cause physiological problems and increase the length
of a patient’s ICU stay. To accurately assess a patient’s
pain level, a behavior-based scale may be more appropriate than self-report methods.
A recent study examined the validity of the Critical-Care Pain Observation
Tool (CPOT) as an alternative method for pain assessment. A group of CPOT-trained
nurses examined a number of TBI patients during non-painful (gentle touch)
and painful (such as turning the patient over) procedures. During these
procedures, patients were asked to self-report their pain levels on the
0-10 Face Pain Thermometer (FPT), while the trained nurses observed the
patients’ behavioral cues and scored their pain using the CPOT.
Researchers found that CPOT scores were significantly higher during painful
procedures, and that these scores correlated significantly with patients’
reported pain levels.
This study indicates that the CPOT is a valid tool for assessing patient
pain after TBI. Because some TBI patients are unable to verbally communicate
after injury, clinicians may need to rely on behavioral cues to determine
these patients’ pain levels and deliver appropriate treatment. The
CPOT is a reliable option for observational pain assessment, and it may
increase quality of ICU care for non-communicative TBI patients.
Source: Joffe AM, McNulty B, Boitor M, et al. Validation of the Critical-Care
Pain Observation Tool in brain-injured critically ill adults. Journal
of Critical Care. (August 2016).