Description

The Échelle Douleur Inconfort Nouveau-né (EDIN) scale is based on observable behavioral and physiological signs of pain and discomfort in newborns. It includes the following five categories:

Face: Observation of facial expressions such as frowning, stretching, or facial muscle contractions.
Sleep/Wakefulness: Assessment of sleep or wakefulness state and the newborn’s ability to self-soothe.
Crying: Observation of crying as an indicator of pain or discomfort, including its duration and intensity.
Body Posture: Evaluation of body posture and muscle tension.
Reaction to Care: Observation of the newborn’s response during care or handling.

Analysis

Analysis of the EDIN results involves scoring each category from 0 to 3 based on the intensity of the observed response. The total score ranges from 0 to 15.

Total Score: The sum of the scores from all five categories.

0–4: Minimal to no pain.
5–10: Mild to moderate pain.
11–15: Severe pain.

Observation of Reactions: Based on the newborn’s physiological and behavioral responses during rest and caregiving.

Purpose

The primary goals of the EDIN are:

Pain and Discomfort Assessment: To provide a reliable tool for assessing pain in newborns, who cannot express pain verbally.
Improved Care: To guide healthcare professionals in managing pain through targeted interventions.
Minimizing Impact: To reduce discomfort and potential developmental consequences of pain in neonates.

Calibration

Calibration of the EDIN includes:

Staff Training: Healthcare professionals are trained to recognize and accurately record signs of pain.
Systematic Observation: Continuous monitoring and documentation of behavioral responses to assess the effectiveness of interventions.
Use of Defined Thresholds: Scoring thresholds are used to evaluate the need for analgesic interventions.

References

Debillon, T., Zupan, V., Ravault, N., Magny, J. F., & Dehan, M. (2001). Development and initial validation of the EDIN scale, a new tool for assessing prolonged pain in preterm infants. Archives of Disease in Childhood – Fetal and Neonatal Edition, 85(1), F36–F41.
Valkenburg, A. J., de Leeuw, T. G., & Tibboel, D. (2015). Pain management in neonates. Pediatric Anesthesia, 25(10), 1006–1020.
Goubet, N., & Rattaz, C. (2003). The study of infants’ pain expression by different care methods. Pain Management Nursing, 4(4), 167–173.