Hello, I am Debra Neiman, RN BSN.

I have worked in Neonatal Care, at Beauregard Memorial Hospital, DeRidder for over four years. My college experience at Louisiana State University at Alexandria, resulted in a great deal of research papers, which are gathering dust in my office. My curriculum at Northwestern State University also added to this wealth of information.

I hereby begin this series to provide a way to get this information to those in the nursing field and any other person with a passing interest in these subjects.

Feel free to reference or use this information in your practice. However,Please respect my Copyright and do not "BORROW" for your HOMEWORK assignments.


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Pain Evaluation Tool
For Use During
Newborn Circumcision
APPENDIX A

Debra Neiman, RN, BSN, Spring 1995

Prepared as Research Proposal
for Nursing Professional Transition Seminar

Northwestern State University


CHAPTER ONE - INTRODUCTION

CHAPTER TWO - LITERATURE REVIEW

CHAPTER THREE - METHODOLOGY

REFERENCES

APPENDICES:


Postoperative Comfort Scale


BEHAVIOR 0
Poor
1
Mediocre
2
Satisfactory
1. Sleep during preceeding hour
    - None . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    - Short naps between 5 and 10 minutes . . . . . . . . . . . . . .
    - Longer naps > 10 minutes . . . . . . . . . . . . . . . . . . . . . .

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2. Facial expression of pain
    - Marked, constant . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    - Less marked, intermittent . . . . . . . . . . . . . . . . . . . . . .
    - Calm, relaxed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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3. Quality of cry
    - Screaming, painful, high-pitched. . . . . . . . . . . . . . . . . .
    - Modulated (can be distracted by normal sound). . . . . . .
    - No cry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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4. Spontaneous motor activity
    - Thrashing around, incessant agitation . . . . . . . . . . . . . .
    - Moderate agitation . . . . . . . . . . . . . . . . . . . . . . . . . . .
    - Normal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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5. Spontaneous excitability, responsiveness to ambient stimulation
    - Tremulous, clonic movements, spont. Moro reflexes . . .
    - Excessive reactivity . . . . . . . . . . . . . . . . . . . . . . . . . .
    - Quiet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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6. Flexion of fingers and toes
    - Very pronounced, marked & constant . . . . . . . . . . . . .
    - Less marked, intermittent . . . . . . . . . . . . . . . . . . . . . .
    - Absent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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7. Sucking
    - Absent or disorganized sucking . . . . . . . . . . . . . . . . . .
    - Intermittent(3 or 4)& stops with crying . . . . . . . . . . . . .
    - Strong, rhythmic with pacifying effect . . . . . . . . . . . . . .

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8. Global evaluation of tone
    - Strong hypertonicity . . . . . . . . . . . . . . . . . . . . . . . . . .
    - Moderate hypertonicity . . . . . . . . . . . . . . . . . . . . . . . .
    - Normal for age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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9. Consolability
    - None after two minutes . . . . . . . . . . . . . . . . . . . . . . .
    - Quiet after one minute of effort . . . . . . . . . . . . . . . . . .
    - Calm before one minute . . . . . . . . . . . . . . . . . . . . . . .

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10. Sociability (eye contact)
response to voice, smile, real interest in face
    - Absent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    - Difficult to obtain . . . . . . . . . . . . . . . . . . . . . . . . . . . .
    - Easy and prolonged . . . . . . . . . . . . . . . . . . . . . . . . . .


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TOTAL SCORE
(a total score of 15-20 indicates
adequate pain management)


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Adapted from:
Attia, J., Amiet-Tison, C., Mayer, M., Shnider, S., & Barrier, G. (1987). Measurement of postoperative pain and narcotic administration in infants using a new clinical scoring system. Anesthesiology, 67, A532.


Copyright, ©1997 Debra Kay Neiman, RN BSN
E-Mail me at: crystalblue@usa.net