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Nonverbal Pain Scale (NVPS) for nonverbal patients

Behavioural and physiological pain assessment for patients unable to self-report pain.

Nonverbal Pain Scale (NVPS) for nonverbal patients
Face
Activity/movement
Guarding
Physiological I (vital signs: heart rate, blood pressure, respiratory rate)
Physiological II (skin, pupils, SpO2)
Result0 / 10

No behavioural or physiological evidence of pain.

When to use

  • Assessing pain in sedated, intubated, or otherwise nonverbal critically ill patients who cannot self-report.

Formula

Sum of 5 domains (face, activity/movement, guarding, physiological I [vital signs], physiological II [skin/SpO2]), each scored 0-2. Range 0-10.

Pearls and pitfalls

  • A behavioural surrogate, not a direct pain measure; treat rising scores as a prompt to reassess analgesia, not a precise pain intensity.

References

  1. Odhner M, et al. Dimens Crit Care Nurs. 2003;22(6):260-267.