Do you use the CPOT scale? What are your med orders?!

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Hey everyone,

My hospital has decided to adopt the CPOT pain scale for our non verbal/vented patients. I am researching for our critical care shared governance committee how a CPOT score might be turned into a medication order so that we can develop a protocol for pain management. THe CPOT scale has been widely validated, but there is little to no scholarly research on this. I consider this to be the case for 2 reasons: the CPOT scale is fairly new and secondly, the author herself maintains that the scale is not a measure of severity of pain but a measure of presence of pain. Therefore, any treatment protocol could only be individualized based on assessment, treatment and reassessment (a reduction in CPOT score by 2 points is considered a "working" treatment; pain management can then be tailored based on specific assessment, dosing and goals).

I'm bringing this to y'all because I know there are ICU's out there that use the CPOT scale and I need to know, if you use this in your institution, how your physicians translate CPOT scores into medication orders. ANY HELP IS APPRECIATED... I've been going round and round on this one...

Thanks!

Eleanor

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Specializes in Critical Care.

Hey. Interested in the answers you receive. We use the CPOT. Our medication orders look no different then if you were assessing pain from a verbal patient. (Moderate to severe). I personally hate the cpot as I feel it is difficult to assess/reassess in the same manner.

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We use the FLACC scale in these situations, but I also work peds.

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Fentanyl IV - titrate to CPOT

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We typically get an order such as Fentanyl gtt, titrate to CPOT of 1. I have seen target scores from 0 to 2, depending on the patient and circumstances. It's almost always paired with sedation, for which we use a different scale.

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Specializes in Trauma Surgical ICU.

We use it often for our vented pts but I find it difficult to use. Most of our pts are heavily sedated or on a roc gtt. The scale in our system also requires a pain location etc. we can't possibly get an answer for that. Drives us in sane.

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RASS for sedation

FLACC or CPOT for pain

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