Opi
Calc
BODE Index (Palliative context)
CAM-S (Confusion Assessment Method - Severity)
CPOT (Critical-Care Pain Observation Tool)
Death Rattle Scoring (Victoria)
Distress Thermometer
Edmonton Symptom Assessment System (ESAS-r)
FAST Scale (Dementia)
IPOS (Integrated Palliative Outcome Scale)
Memorial Symptom Assessment Scale (MSAS)
Menten Score
Morphine Equivalent Daily Dose (MEDD)
Nursing Delirium Screening Scale (Nu-DESC)
Opioid Risk Tool (ORT)
PAINAD Scale
Palliative Performance Scale (PPSv2)
Palliative Prognostic (PaP) Score
Palliative Prognostic Index (PPI)
Respiratory Distress Observation Scale (RDOS)
Richmond Agitation-Sedation Scale (RASS-PAL)
Seattle Heart Failure Model (SHFM)
e-PaP Score
CPOT (Critical-Care Pain Observation Tool)
CPOT: Critical-Care Pain Observation Tool for non-verbal patients in ICU/palliative sedation.
Facial Expression (0-2)
0 - No muscular tension observed
1 - Relaxed, neutral or slight tension
2 - Obvious facial tension/grimace
Body Movements (0-2)
0 - No movement or normal position
1 - Slow, purposeful movements, touch nurses
2 - Frequent non-purposeful movements, pulling tubes
Ventilator Compliance (0-2)
0 - Tolerates ventilator, no fighting
1 - Occasional coughing or breath stacking
2 - Fighting ventilator, coughing, breath stacking
Muscle Tension (0-2)
0 - Relaxed, low muscle tone
1 - Slight increase in muscle tension
2 - Obvious increased tone/rigidity/stiffness
Vocalization (0-2)
0 - No sounds
1 - Occasional sighs, moans, or mumbles
2 - Crying, yelling, or frequent vocalizations
Calculate CPOT Score
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Pain assessment in non-verbal ICU and palliative sedation patients
Monitoring pain in mechanically ventilated patients
Assessment of pain response in critically ill populations
Guiding analgesic titration in sedated patients
Section 2
Formula & Logic
Assessment Components
Facial expression
Body movements
Compliance with ventilator (for intubated patients)
Muscle tension
Vocalization (if present)
Scoring Range
0 points
No pain
1–2 points
Mild pain
3–6 points
Moderate to severe pain
Section 3
Pearls/Pitfalls
Key Advantages
Validated in ICU and palliative care settings
Observational; feasible in non-communicative patients
Brief assessment compatible with busy ICU workflows
Last Comprehensive Review: 2026
Related Palliative Care Tools
Palliative Prognostic
e-PaP Score
Menten Score
Edmonton Symptom Assessment System
IPOS
Distress Thermometer
Memorial Symptom Assessment Scale
Morphine Equivalent Daily Dose
Opioid Risk Tool
PAINAD Scale
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