APPENDIX 1: PIPP PAIN ASSESSMENT TOOL 2026

1. Click ‘Get Form’ to open it in the editor.
2. Familiarize yourself with each indicator on the PIPP tool. Understand how each component is scored, including gestational age, behavioral state, heart rate, and facial expressions.
3. Begin by scoring the gestational age of the infant. This score will be added to the total pain score based on their developmental stage.
4. Next, observe the infant for 30 seconds to assess their behavioral state. Record your observations accurately.
5. Record baseline heart rate and oxygen saturation at the start of your assessment. Monitor these metrics closely during your observation period.
6. After observing for 30 seconds, note any physiological changes and facial expressions immediately following this period.
7. Calculate the total score based on your observations. Use this score to determine if there is minimal, moderate, or severe pain present.

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