Clinical Calculators

BPS (Behavioral Pain Scale)

Behavioral pain assessment in ventilated patients who cannot speak

3 items left

Facial expression
Upper limb movements
Compliance with ventilation

Cautions

  • When the patient can report pain by self-report, use a numeric rating scale (NRS) or a visual analog scale (VAS). BPS is for patients who cannot self-report (J-PAD 2014 CQ3 A3).
  • The scale includes compliance with the ventilator, so it is used in patients on a ventilator. The original scale was developed in sedated critically ill patients.
  • The total ranges from 3 (no pain behavior) to 12. The minimum total is 3, because each item scores at least 1.
  • Do not assess pain by vital signs alone. Even during painful procedures, a rise in blood pressure or heart rate is not a reliable indicator of the degree of pain (J-PAD 2014 CQ4 A4).
  • "BPS > 5" is a guide proposed from observations comparing rest with invasive procedures in adult ICU patients who cannot speak.

References

  1. Payen JF, Bru O, Bosson JL, et al. Assessing pain in critically ill sedated patients by using a behavioral pain scale. Crit Care Med. 2001;29(12):2258-2263. (original not seen) PMID: 11801819, DOI: 10.1097/00003246-200112000-00004[Original article]
  2. J-PAD Guideline Committee, Japanese Society of Intensive Care Medicine. Japanese clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit (J-PAD) (English title translated by the authors of this site; in Japanese). J Jpn Soc Intensive Care Med. 2014;21:539-579. (Table 3 (BPS), CQ3 A3 and CQ4 A4 and their commentary) https://www.jsicm.org/pdf/2015-J-PAD-guideline.pdf[Guideline]
  3. Hsiung NH, Yang Y, Lee MS, Dalal K, Smith GD. Translation, adaptation, and validation of the behavioral pain scale and the critical-care pain observational tools in Taiwan. J Pain Res. 2016;9:661-669. (Table 3) PMID: 27695360, DOI: 10.2147/jpr.s91036, https://pmc.ncbi.nlm.nih.gov/articles/PMC5029847/[Review article]

Checked on: 2026-10-13

Disclaimer

This calculation is intended to support the judgment of healthcare professionals. Results are for reference only; decisions about diagnosis and treatment must be made by the responsible healthcare professional. The values you enter never leave your device.