Validation of the Critical-Care Pain Observation Tool in Brain-Injured Critically Ill Adults

Man with Palm on Face
Pain is a common consequence of traumatic brain injury ( TBI), 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).
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