Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) in Young Children

Patients:

(1) The initial study was done on children 1 to 5 years of age.

(2) It has been used in studies with adolescents but this may not be an appropriate instrument for that age group.

(3) According to Mitchell (1999) it is intended for ages 0-4.

where:

• no cry: child is not crying

• moaning: child is moaning or quietly vocalizing, silent cry

• crying: child is crying, but the cry is gentle or whimpering

• screaming: child is in a full-lunged cry; sobbing may be scored with complaint or without complaint

• smiling: score only if definite positive facial expression

• composed: neutral facial expression

• grimace: score only if definite negative facial expression

• positive (verbal): child makes any positive statement or talks about other things without complaint

• none (verbal): child not talking

• complaints other than pain: child complains but not about pain ("I want to see mommy: or "I am thirsty")

• pain complaints: child complains about pain

• both pain and non-pain complaints: child complains about pain and about other things (e.g., "It hurts; I want mommy.")

• neutral (torso): body (not limbs) is at rest; torso is inactive

• shifting: body is in motion in a shifting or serpentine fashion

• tense: body is arched or rigid

• shivering: body is shuddering or shaking involuntarily

• upright: child is in a vertical or upright position

• restrained: body is restrained

• not touching: child is not touching or grabbing at wound

• reach: child is reaching for but not touching wound

• touch: child is gently touching wound or wound area

• grab: child is grabbing vigorously at wound

• restrained: child's arms are restrained

• neutral (legs): legs may be in any position but are relaxed; includes gently swimming

• squirming, kicking: definitive uneasy or restless movements in the legs and/or striking out with foot or feet

• drawn up, tensed: legs tensed and/or pulled up tightly to body and kept there

• standing: standing, crouching or kneeling

• restrained: child's legs are being held down

CHEOPS pain score =

= SUM(points for all 6 parameters)

Interpretation:

• minimum score: 4

• maximum score: 13