Pre-Verbal, Early Verbal Pediatric Pain Scale (PEPPS)

Parameter

Finding

Points

heart rate

baseline range (< 10 beats/minute above)

0

10-20 beats/minute above baseline

1

21-30 beats/minute above baseline

2

31-40 beats/minute above baseline

3

> 40 beats/minute above baseline

4

facial

relaxed facial expression

0

grimace, brows drawn together, eyes partially closed, squinting

2

severe grimace, brows lowered and tightly drawn together, eyes tightly closed

4

cry

no cry

0

whimpering, groaning, fussiness

1

intermittent crying

2

sustained crying

3

screaming

4

consolability, state of restfulness

pleasant, well integrated

0

distractable, easy to console, intermittent fussiness

1

able to console, distract with difficulty, intermittent restlessness, irritability

2

unable to console, restlessness, sustained movement

4

body posture

body at rest, relaxed positioning

0

clenched fists, curled toes, and/or reaching for or touching wound area

1

localization with extension or flexion

2

stiff and nonmoving

2

intermittent or sustained movement with or without periods of rigidity

3

sustained arching, flailing, thrashing and/or kicking

4

sociability

sleeping

0

responds to voice and or/touch, makes eye contact and/or smiles, easy to obtain and maintain

0

responds to voice and/or touch with effort, makes eye contact, difficult to obtain and maintain

2

absent eye contact, absent response to voice and/or touch

4

sucking/feeding

not applicable (NA)

0

NPO or oral stimuli not used

0

sucking, drinking, and/or eating well

0

disorganized sucking

1

attempting to eat or drink but discontinues

1

lack of sucking, refusing food or fluids

2