Intensive care units frequently have patients that are unable to verbally communicate their pain, thus negating conventional pain assessment techniques and making pain assessment difficult. Pain management is often a priority in all patients’ circumstances and therefore, assessment and reassessment are included in the plan of care. Different observational pain scales have been used in intensive care units, but often times these scales must be adapted to fit the patient’s circumstances. Pain scales that are used for nonverbal patients typically include behavioral indicators and some are adapted to incorporate physiologic indicators such as vital signs. The aim of this review is to determine if the use of the Critical-Care Pain Observation Tool (CPOT), an assessment tool that is strictly observational, leads to more accurate pain assessment scores for nonverbal adult patients in comparison to the Adult Nonverbal Pain Scale (NVPS), a tool that incorporates vital signs. A search was conducted using five databases and the key words included, but are not limited to, Critical-Care Pain Observation Tool, Adult Nonverbal Pain Scale, nonverbal patients, and pain assessment. It was found that the CPOT was more accurate in determining pain assessment scores due to a discrepancy regarding the inconsistency of vital signs
