Table 1.

Modified NIPS Pain Assessment Scale

Behavior Score
Facial expressionRelaxed musclesTight facial muscles
Neutral expressionFurrowed brow, chin, jaw
CryQuiet—not cryingMild moaning—intermittent cryLoud scream, rising shrill continuous
Breathing patternsRelaxedChanges in breathing; irregular, faster than usual, gagging, breath holding
ArmsRelaxedFlexed/extended tense, straight arms, rigid and/or rapid extension, flexion
No muscular rigidity
Occasional random
Movements of arms
State of arousalSleeping/awakeFussy
Quiet, peaceful, sleeping, or alert and settledAlert, restless, and thrashing