• B F Fuller.
• School of Nursing, University of Colorado Health Sciences Center, Denver, USA. barbara.fuller@uchsc.edu
• J Soc Pediatr Nurs. 2001 Jul 1;6(3):109-15.

Issues And PurposeMany infant pain assessment tools use infant behaviors indicative of increased arousal. These tools were developed and tested using clinical situations involving acute immediate pain responses. Are these behaviors valid, clinical indicators of acute established pain (non-procedurally caused) pain? Can these tools be used to assess acute established infant pain? This article explores research findings to answer these questions.ConclusionsFindings suggest that behaviors indicative of increased arousal (e.g., crying, facial expressions that accompany crying) are nonspecific indicators of distress rather than independent indicators of established acute pain. Thus, the use of behaviors representing acute immediate pain responses to assess acute established pain, or the use of tools that incorporate these behaviors, can be misleading.Practice ImplicationsAlways use acute immediate pain behavioral responses (behaviors indicative of increased arousal) in conjunction with clinical data concerning "likelihood of pain" and consolability.

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