Description

The CRIES Pain Scale is a tool used to assess pain in neonates and infants, particularly in Neonatal Intensive Care Units (NICU). It is one of the first tools specifically designed to evaluate pain in this population and includes the observation of specific physiological and behavioral reactions.

Overview

The CRIES Pain Scale consists of five elements that assess the infant’s response to pain. These elements include:
Crying: Assesses the infant’s crying, as prolonged or unusual crying may indicate pain.
Requires increased oxygen administration: The need for more oxygen can indicate physiological stress associated with pain.
Increased vital signs: Assesses the increase in vital signs such as heart rate and blood pressure.
Expression: Observes facial expressions, such as furrowing of the brow, lip stretching, or other signs of pain.
Sleeplessness: Assesses the infant’s difficulty in falling or staying asleep.

Analysis

The CRIES scale is analyzed based on the observation of the above elements, where each element is rated from 0 to 2. The total score can range from 0 to 10.
• 0: No pain indication
• 1-3: Mild pain
• 4-6: Moderate pain
• 7-10: Severe pain
Observation is typically conducted after procedures that may cause pain, such as surgical interventions or medical treatments.

Goal

The main goal of the CRIES Pain Scale is to reliably assess pain in neonates to allow for immediate and appropriate management. Healthcare professionals use the scale to:
Pain Management: Provide analgesics or other interventions to alleviate pain.
Improving Care: Adjust care practices based on the infant’s pain responses.
Reducing Pain Impact: Minimize stress and potential complications associated with insufficient pain control.

Scoring

The scoring of the CRIES scale is based on the systematic observation of the elements by clinical doctors: Total Score: The sum of the scores from the five elements. Intervention Points: A total score of 4 or higher generally requires interventions for pain management.

References

Krechel, S. W., & Bildner, J. (1995). CRIES: A new neonatal postoperative pain measurement score. Initial testing of validity and reliability. Paediatric Anaesthesia, 5(1), 53-61.
Hudson-Barr, D., & Capper-Michel, B. (2002). Neonatal pain assessment: Validity and reliability of the CRIES scale. Neonatal Network, 21(4), 15-21.
Hummel, P., & van Dijk, M. (2006). Pain assessment: Current status and challenges. Seminars in Fetal and Neonatal Medicine, 11(4), 237-245.