Version June 2024
| Infant indicator | Indicator score | Infant indicator score | |||
| 0 | +1 | +2 | +3 | ||
| Change in heart rate (bpm) Baseline: __________ | 0 to 4 | 5 to 14 | 15 to 24 | >24 | |
| Decrease in oxygen saturation (%) Baseline: __________ | 0 to 2 | 3 to 5 | 6 to 8 | >8 or increase in O2 | |
| Brow bulge (sec) | None (<3) | Minimal (3 to 10) | Moderate (11 to 20) | Maximal (>20) | |
| Eye squeeze (sec) | None (<3) | Minimal (3 to 10) | Moderate (11 to 20) | Maximal (>20) | |
| Naso-labial furrow (sec) | None (<3) | Minimal (3 to 10) | Moderate (11 to 20) | Maximal (>20) | |
| Subtotal score:* | |||||
| Gestational age (weeks + days) | >36 weeks | 32 to 35 weeks, 6 days | 28 to 31 weeks, 6 days | <28 weeks | |
| Baseline behavioural state | Active and awake | Quiet and awake | Active and asleep | Quiet and asleep | |
| Total score:¶ | |||||
| Scoring instructions | |||||
| Step 1: Observe infant for 15 seconds at rest and assess vital sign indicators [highest heart rate (HR) and lowest O2 saturation (O2 SAT)] and behavioural state. | |||||
| Step 2: Observe infant for 30 seconds after procedure and assess change in vital sign indicators (maximal HR, lowest O2 SAT and duration of facial actions observed).Δ | |||||
| Step 3: Score for corrected gestational age (GA) and behavioural state (BS) if the subtotal score >0. | |||||
| Step 4: Calculate total score by adding subtotal score + BS score. | |||||
PIPP-R: premature infant pain profile-revised; BS: behavioral state; GA: gestational age.
* Subtotal for physiological and facial indicators. If subtotal score >0, add GA and BS indicator scores.
¶ Total score: subtotal score + GA score + BS score.
Δ If infant requires an increase in oxygen at any point before or during procedure, they receive a score of 3 for the O2 SAT indicator.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
