The Critical-Care Pain Observation Tool (CPOT) assesses pain in critically ill adults who can't self-report, including intubated and sedated patients. It scores four behaviours from 0 to 2: facial expression, body movements, muscle tension, and either ventilator compliance or vocalisation.
Céline Gélinas and colleagues validated it in 2006, and it's one of the two behavioural pain scales recommended in the critical care pain, agitation and delirium guidelines.
Zdrovia: https://www.zdrovia.ca/resources/cpot-pain-scale/
ICU Pain Assessment
Critical-Care Pain Observation Tool (CPOT)
Score four behaviours from 0 to 2 for a total out of 8. Use either ventilator compliance (intubated) or vocalisation (extubated) for the fourth item.
Intubated: ventilator compliance. Extubated: vocalisation.
Total score
0 of 4 items scored
Score every item to see the result
Item breakdown
These results are estimates based on published clinical data and are for informational purposes only. They do not constitute medical advice, a diagnosis, or a treatment recommendation. Consult a licensed aesthetic practitioner before beginning any treatment. Individual results vary.
Zdrovia's smart blocks drop validated scales into the visit note, keep every item score, and graph the total across visits so the trend is visible at a glance. See how smart blocks work →
CPOT scoring
| Indicator | 0 | 1 | 2 |
|---|---|---|---|
| Facial expression | Relaxed, neutral | Tense | Grimacing |
| Body movements | Absent or normal position | Protection | Restlessness |
| Muscle tension | Relaxed | Tense, rigid | Very tense or rigid |
| Ventilator compliance (intubated) | Tolerating ventilator | Coughing but tolerating | Fighting ventilator |
| or Vocalisation (extubated) | Normal tone or no sound | Sighing, moaning | Crying out, sobbing |
Total 0–8. A score above 2 suggests significant pain.
Score it straight into the chart
Zdrovia's smart blocks drop validated scales into the visit note, keep every item score, and graph the total across visits so the trend is visible at a glance.
How to use CPOT
Observe the patient for one minute at rest to get a baseline, then during a procedure known to be painful, such as turning or suctioning. Score muscle tension with passive flexion and extension of the arm. Use ventilator compliance for intubated patients and vocalisation for extubated patients, not both.
A score above 2 suggests unacceptable pain. Reassess after giving analgesia, and record the score and intervention together so the response is clear.
Other pain scales: Pain scale 0–10 and which scale to use →
Other clinical assessment references