| Item | Description | Score |
|---|
| Facial expression | Relaxed
Partially tightened (e.g., brow lowering)
Fully tightened (e.g., eyelid closing)
Grimacing | 1
2
3
4 | | Upper limbs | No movement
Partially bent
Fully bent with finger flexion
Permanently retracted | 1
2
3
4 | | Compliance with ventilation | Tolerating movement
Coughing but tolerating ventilation for most of the time
Fighting ventilator
Unable to control ventilation | 1
2
3
4 |
Reprinted with permission from - Payen, J., Bru, O., Bosson, J., Lagrasta, A., Novel, E., Deschaux, L., & Jacquot, C. (2001). Assessing pain in critically ill sedated patients by using a behavioral pain scale. Critical Care Medicine, 29(12), 2258-2263. https://doi.org/10.1097/00003246-200112000-00004
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