True statement regarding pain management in critical care

It is estimated that >70% of critical care patients remember experiencing pain during their critical care stay. The BPS is composed of three observational areas (facial expression, upper limb movements and compliance with mechanical ventilation). Each is scored from 1 to 4, with higher numbers indicating discomfo. The BPS score ranges from 3 (no pain) to 12 (most pain). It has been studied and validated in both deeply sedated and moderately sedated patients. The CPOT assesses four areas (facial expression, movements, muscle tension and ventilator compliance). Each area is scored from 0-2, with total scores ranging from 0 (no pain) to 8 (most pain). It is validated in both intubated and non-intubated critical care patients. CPOT has superior reliability and validity when used in non-verbal critically ill adults. Chronic pain or delirium may make asceaining a pain level difficult with CPOT. Uncontrolled pain is common in critically ill patients. Uncontrolled pain is associated with many adverse physiological and psychological consequences and may cause increased overall morbidity and death. Consequences include: arrhythmias, immune system alteration, increased catecholamine and coisol release, depression, anxiety and post-traumatic stress disorder.Refrence: Stites M. Observational pain scales in critically ill adults. Crit Care Nurs 2013; 33(3):68-79.2. Barr J, Puntillo K, Ely EW, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med 2013; 41(1): 263-306.