Modified pain assessment tool (mPAT)

The mPAT is an observational scale designed to assess neonatal pain. The mPAT has been validated for surgical and non-surgical neonates, from 24 weeks gestation to full term, up to 6 months old.

The mPAT scale focuses on behavioural and physiological responses to painful stimuli, and includes a nurse’s perception indicator.

How to complete the mPAT Score

Each item is scored from 0 to 2, and added to generate a total score out of 20 (the higher the score, the higher the level of pain).

Frequency of assessment will depend on the clinical situation.  If pain is a concern, assess more frequently.

Assessment	Observation	Score
Posture/tone	Normal/relaxed	0
	Extended	1
	Flexed and/or tense	2
Sleep pattern	Relaxed	0
	Easily woken	1
	Agitated or withdrawn	2
Expression	Normal/relaxed	0
	Frown	1
	Grimace	2
Cry	No	0
	Yes, consolable	1
	Yes	2
Colour	Pink/normal	0
	Occasionally mottled/pale	1
	Pale/dusky/flushed	2
Respirations	Normal baseline rate	0
	Tachypnoea	1
	Apnoea/splinting	2
Heart rate	Normal baseline rate	0
	Tachycardia	1
	Fluctuating	2
Oxygen saturation	Normal	0
	Fleeting desaturation	1
	Desaturating	2
Blood pressure	Normal	0
	Fluctuates with handling	1
	Hypotensive or hypertensive	2
Nurses perception	No pain	0
	Pain with handling	1
	Yes pain	2
Total score

Adapted from O’Sullivan et al. (2016). Table reproduced, with permission, from: The Royal Children's Hospital Melbourne, Clinical Guidelines (Nursing): Neonatal Pain Assessment.