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REVIEW article

Front. Pain Res.
Sec. Clinical Trials, Methods, and Evidence Synthesis
Volume 5 - 2024 | doi: 10.3389/fpain.2024.1481085

Evaluating Pain in Non-Verbal Critical Care Patients: A Narrative Review of the Critical Care Pain Observation Tool and Its Clinical Applications

Provisionally accepted
Abebe D. Afenigus Abebe D. Afenigus *
  • Debre Markos University, Debre Marqos, Ethiopia

The final, formatted version of the article will be published soon.

    Background: Assessing pain in critically ill patients who cannot communicate verbally poses significant challenges. Traditional self-report measures are ineffective for these patients, making the need for reliable observational tools crucial. Objective: To evaluate the effectiveness, reliability, and clinical applicability of the Critical Care Pain Observation Tool (CPOT) in various intensive care unit (ICU) settings and to explore potential innovations for improving its use and integration into clinical practice Methods: A narrative review evaluated the Critical Care Pain Observation Tool (CPOT) for non-communicative ICU patients, comparing it to the Behavioral Pain Scale (BPS) and the FLACC scale. The review assessed CPOT’s effectiveness across different ICU settings, identified limitations and challenges, and explored potential enhancements such as electronic scoring, additional physiological indicators, and improved training protocols. Results: The CPOT has been validated as an effective pain assessment tool for non-verbal ICU patients. It evaluates pain through facial expressions, body movements, muscle tension, and ventilator compliance. The CPOT shows superior sensitivity at 76.5% compared to 62.7% for the BPS and offers a more comprehensive assessment of pain indicators like muscle tension and ventilator compliance than the FLACC scale. Despite its strengths, the CPOT has limitations, including inter-rater variability and challenges in certain patient populations. Barriers to implementation include resource constraints and the need for extensive training. Conclusion: The Critical Care Pain Observation Tool (CPOT) is a highly effective instrument for assessing pain in non-verbal ICU patients, demonstrating superior accuracy and reliability compared to other tools like the Behavioral Pain Scale (BPS) and FLACC scale. Its detailed approach, covering facial expressions, body movements, muscle tension, and ventilator compliance, offers a detailed measure of pain. However, challenges such as inter-rater variability and limitations in specific patient populations highlight the need for ongoing refinement and research.

    Keywords: Pain evaluation, non-verbal patient, Critical Care, Critical Care Pain Observation Tool, clinical applications

    Received: 15 Aug 2024; Accepted: 30 Sep 2024.

    Copyright: © 2024 Afenigus. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Abebe D. Afenigus, Debre Markos University, Debre Marqos, Ethiopia

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.