🩹 Critical-Care Pain Observation Tool (CPOT)
UseUse to assess pain in nonverbal/sedated/ventilated ICU patients by scoring four behavioral domains.
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SourcePADIS guidelines. Crit Care Med 2018.
Runs locally in your browser (no PHI uploaded). For licensed clinicians — not a substitute for clinical judgement.
Stored on this device for revisit reminders
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
Scene next step
📋sedation deliriumOpen scene pack →Matching pathway
🧭benzo_odOpen pathway →Score + version; reference only — not a substitute for care · no HIS write
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Methodology · worked example, guidelines & full notes
Clinical takeaway
CPOT relies on observable behavior, making it usable when self-report is impossible (original synthesis · not guideline verbatim).
When to use
Use to assess pain in nonverbal/sedated/ventilated ICU patients by scoring four behavioral domains.
How it works
Four domains (facial expression, body movements, muscle tension, and ventilator compliance or vocalization) each scored 0–2; total 0–8.
Key points
- CPOT relies on observable behavior, making it usable when self-report is impossible (original synthesis · not guideline verbatim).
- Self-report remains the gold standard whenever the patient can communicate.
References
- [Guideline / primary source]PADIS guidelines. Crit Care Med 2018.
- Gélinas C, et al. CPOT validation. Am J Crit Care 2006.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Facial expression | Tense (frowning/brow lowering) (1) |
|---|---|
| Body movements | Protection (slow cautious touching of the painful area) (1) |
| Muscle tension (passive flexion/extension of the upper limb) | Tense, rigid (1) |
| Ventilator compliance (intubated) / vocalization (extubated) | Coughing but tolerating/sighing or moaning (1) |
→CPOT4 pts
- Total：4 pts (max 8) → > 2: significant pain present
- Management direction：reassess
- Note：CPOT has 4 items each 0–2 (facial expression, body movements, muscle tension, ventilator compliance/vocalization), total 0–8; cutoff > 2 indicates significant pain. Observe at rest for 1 minute for a baseline, then reassess during noxious procedures; suitable for patients unable to self-report (intubated/sedated/altered consciousness)
| Facial expression | Relaxed, neutral (0) |
|---|---|
| Body movements | No movement/normal (0) |
| Muscle tension (passive flexion/extension of the upper limb) | Relaxed (0) |
| Ventilator compliance (intubated) / vocalization (extubated) | Tolerating ventilation/normal vocalization (0) |
→CPOT0 pts
- Total：0 pts (max 8) → ≤ 2: no significant pain
- Management direction：reassess regularly before and after procedures (turning, suctioning, etc. can provoke pain)
- Note：CPOT has 4 items each 0–2 (facial expression, body movements, muscle tension, ventilator compliance/vocalization), total 0–8; cutoff > 2 indicates significant pain. Observe at rest for 1 minute for a baseline, then reassess during noxious procedures; suitable for patients unable to self-report (intubated/sedated/altered consciousness)
Verification & sources · governance
FAQ
Frequently asked questions
- What are the limits and cautions when using Critical-Care Pain Observation Tool (CPOT)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- Does Critical-Care Pain Observation Tool (CPOT) upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is Critical-Care Pain Observation Tool (CPOT) calculated in practice? Can you show a worked example?
- Inputs: Facial expression Tense (frowning/brow lowering) (1), Body movements Protection (slow cautious touching of the painful area) (1), Muscle tension (passive flexion/extension of the upper limb) Tense, rigid (1), Ventilator compliance (intubated) / vocalization (extubated) Coughing but tolerating/sighing or moaning (1) → Result: CPOT 4 pts（Total: 4 pts (max 8) → > 2: significant pain present, Management direction: reassess, Note: CPOT has 4 items each 0–2 (facial expression, body movements, muscle tension, ventilator compliance/vocalization), total 0–8; cutoff > 2 indicates significant pain. Observe at rest for 1 minute for a baseline, then reassess during noxious procedures; suitable for patients unable to self-report (intubated/sedated/altered consciousness)） Inputs: Facial expression Relaxed, neutral (0), Body movements No movement/normal (0), Muscle tension (passive flexion/extension of the upper limb) Relaxed (0), Ventilator compliance (intubated) / vocalization (extubated) Tolerating ventilation/normal vocalization (0) → Result: CPOT 0 pts（Total: 0 pts (max 8) → ≤ 2: no significant pain, Management direction: reassess regularly before and after procedures (turning, suctioning, etc. can provoke pain), Note: CPOT has 4 items each 0–2 (facial expression, body movements, muscle tension, ventilator compliance/vocalization), total 0–8; cutoff > 2 indicates significant pain. Observe at rest for 1 minute for a baseline, then reassess during noxious procedures; suitable for patients unable to self-report (intubated/sedated/altered consciousness)）