Imagine how difficult it is to understand the severity of pains in people who are unable to communicate their pains and children between ages 2 months and 7 years, it’s quite tasking and stressful, right?
Quick Facts About FLACC Scale
| A | B |
|---|---|
| Full Name | FLACC Scale (Face, Legs, Activity, Cry, Consolability) |
| Purpose | To assess pain in young children and individuals unable to communicate their pain verbally |
| Developed By | Sandra Merkel, MS, RN, and colleagues at the University of Michigan Health System |
| Year of Development | 1997 |
| Validation | Validated through various studies for reliability and effectiveness in different settings |
| Target Group | Infants and young children (typically 2 months to 7 years) or individuals who are non-verbal |
| Scoring Range | 0 to 10 |
| Components | Five categories: Face, Legs, Activity, Cry, Consolability |
| Scoring Method | Each category is scored from 0 to 2, with 0 indicating no pain and 2 indicating severe pain |
| Interpretation | 0 = Relaxed and comfortable, 1-3 = Mild discomfort, 4-6 = Moderate pain, 7-10 = Severe discomfort/pain |
| Face | 0 = No particular expression or smile, 1 = Occasional grimace or frown, 2 = Frequent to constant frown |
| Legs | 0 = Normal position or relaxed, 1 = Uneasy, restless, tense, 2 = Kicking, or legs drawn up |
| Activity | 0 = Lying quietly, normal position, moves easily, 1 = Squirming, shifting back and forth, 2 = Arched, rigid, or jerking |
| Cry | 0 = No cry (awake or asleep), 1 = Moans or whimpers; occasional complaint, 2 = Crying steadily, screams or sobs, frequent complaints |
| Consolability | 0 = Content, relaxed, 1 = Reassured by occasional touching, hugging or talking to, distractible, 2 = Difficult to console or comfort |
| Use in Clinical Settings | Commonly used in pediatric settings, intensive care units, and post-operative care |
| Advantages | Simple, quick, effective for non-verbal patients |
| Limitations | May not be as accurate for chronic pain assessment, relies on observer's interpretation |
| Training Required | Minimal; healthcare providers can quickly learn to use the scale |
| Revised Version | Revised-FLACC (r-FLACC) includes more detailed descriptors for each category to enhance accuracy |
| Application in Special Population | Adapted for use in individuals with cognitive impairments, including dementia |
| Comparison with Other Scales | Often compared with other pediatric pain scales like the Wong-Baker FACES Pain Rating Scale and the CHEOPS (Children's Hospital of Eastern Ontario Pain Scale) |
| Recommended Frequency of Use | During initial assessment, post-operative period, and regular intervals thereafter |
| Accessibility | Widely accessible and used globally in various healthcare settings |
This is where the flacc scale comes in. The Flacc scale is a behavioral pain scale used to assess a person’s pain, especially those unable to communicate.
Doctors often use the flacc scale to determine the pain levels of people who can’t speak out to express the level of pain they are experiencing, and also the flacc scale is very beneficial for accessing the pain levels of infants (since they can’t talk yet).
So, the flacc scale makes healthcare/treatment much easier as it helps doctors to be able to make accurate diagnosis/prognosis for patients who are not able to communicate the levels of pain they are feeling.
So in this article, Healthsoothe is gonna expatiate on all there is to know about the flacc pain scale; what it is? Where can you get it? Who can do it? Does it have any side effects? How much does it cost? And much more.
We move.
Explaining the Flacc Scale
The FLACC scale, or Face, Legs, Activity, Cry, Consolability scale1Voepel-Lewis T, Zanotti J, Dammeyer JA, Merkel S (2010). "Reliability and validity of the face, legs, activity, cry, consolability behavioral tool in assessing acute pain in critically ill patients". Am. J. Crit. Care. 19 (1): 55–61. doi:10.4037/ajcc2010624. PMID 20045849. is a pain assessment tool for children aged 2 months to 7 years and adults who cannot verbalize their pain2https://en.wikipedia.org/wiki/FLACC_scale.
The scale is graded from 0 to 10, with 0 denoting no discomfort. The scale comprises five criteria, each with a value of 0, 1, or 2. The flacc scale makes it easier for the doctor to understand the severity and type of pain.
Criteria for the FLACC Behavioural Pain Scale.
| Behaviour | 0 | 1 | 2 |
| Face | No particular expression or smile | Occasional grimace or frown, withdrawn, disinterested | Frequent to constant quivering chin, clenched jaw |
| Legs | Normal position or relaxed | Uneasy, restless, tense | Kicking or legs drawn up |
| Activity | Lying quietly, normal position, moves easily | Squirming, shifting, back and forth, tense | Arched, rigid or jerking |
| Cry | No cry (awake or asleep) | Moans or whimpers; occasional complaint | Crying steadily, screams, sobs, frequent complaints |
| Consolability | Content, relaxed | Reassured by touching, hugging or being talked to, distractible | Difficult to console or comfort |
How to Use Flacc Scale
Two sets of instructions for the observer depend on if the patient is awake or asleep.
For awake patients:
- Observe for at least 2-5 minutes
- Observe the uncovered legs and body
- Reposition the patient or observe activity; assess the body for tenseness and tone
- If needed, initiate consoling interventions.
For asleep patients:
- Observe for a minimum of 5 minutes
- Observe the uncovered legs and body
- Reposition the patient, if possible
- Touch the body and assess the tenseness and tone
There are five categories, and each category is scored on a 0-2 scale which results in a total score of 0-10.
Interpretation of Flacc pain score - Assessment of Behavioural Score
- 0 → Relaxed and comfortable
- 1-3 → Mild discomfort
- 4-6 → Moderate pain
- 7-10 → Severe discomfort and pain
Does the Flacc Scale Have Any Side Effects?
Flacc pain scale doesn’t have any side effects as it is a non-invasive process, and rather simple to do, if you know what you are doing. And it also doesn’t take time, and many health practitioners use this method to determine a patient’s pain levels even if that person can talk or express their pain levels vocally.
Who Can Perform a Flacc Scale Test? – Can Anyone Do It?
Yes, anyone can perform a flacc scale test, provided he/she has the knowledge required to do it. It’s a non-invasive process, which can be done anywhere and anytime, and it doesn’t require much time and effort.
Where Can You Get a Flacc Scale or Undergo a Flacc Pain Scale Test?
A flacc pain scale test can be done at any professional health center like hospitals and clinics. The test can also be done at home if you have been taught well about it, or you have your doctor come over and test you.
Where Can You Buy a Flacc Scale?
Flacc scale reference cards can be bought at a hospital, a well-stocked pharmacy, and even online stores like Amazon, Walmart, and also on virtual drug stores.
How Much Does a Flacc Scale Cost?
The Flacc scale reference cards cost from $11 to $13 dollars depending on the place you are buying them from. Make sure to buy from top recommended sources.
Conclusion
The Flacc scale was originally designed and validated for use in infants and children aged 2 months to 7 years to measure postoperative pain3FLACC Scale Archived 2008-12-10 at the Wayback Machine (Extracted from The FLACC: A behavioral scale for scoring postoperative pain in young children, by S Merkel and others, 1997, Pediatr Nurse 23(3), p. 293–297), but the FLACC scale has also been found to be accurate for use with adults in intensive-care units (ICU) who are unable to speak due to intubation. The FLACC scale offered the same evaluation of pain as did the Checklist of Nonverbal Pain Indicators (CNPI) scale which is used in ICUs.
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Frequently Asked Questions Related to the Flacc Scale
What Age Group is Flacc Scale Used?
The Flacc scale was originally designed and validated for use in infants and children aged 2 months to 7 years to measure postoperative pain, but the FLACC scale has also been found to be accurate for use with adults in intensive-care units (ICU) who are unable to speak due to intubation.
What is the Benefit of the FLACC Scale?
The FLACC scale or Face, Legs, Activity, Cry, Consolability scale is a measurement used to assess pain for children between the ages of 2 months and 7 years or individuals that are unable to communicate their pain. The scale is scored in a range of 0–10 with 0 representing no pain.
What is the Recommended Age for the FLACC Scale?
Infants and children aged 2 months to 18 years. Target populations include children with mild to severe cognitive impairments, developmental delay, and cerebral palsy.
What Pain Assessment Scale is Best for a Toddler?
The FLACC (faces, legs, activity, cry, consolability) scale is an easy-to-use tool that helps measure pain in children who are too young to talk. The FLACC scale uses a checklist to assess pain by watching for facial expressions, body movements, body posture, crying, activity, and appearance.
Which Scale is Most Appropriate for Assessing Pain in a Newborn?
The premature infant pain profile (PIPP) is a validated pain scoring system for preterm neonates. For infants, non-verbal young children, and patients with cognitive impairment, the face, legs, activity, crying, and consolability (FLACC) scale or the revised FLACC scale can be used.
What Pain Scale is Used for School-Age Children?
Remember that for children it is often useful to substitute the terms “ouch” or “hurt” for the word “pain”. The numeric rating scale may be categorized into no pain (0), mild pain (1-3), moderate pain (4-6), and severe pain, (7-10). These categories have been used in the past to indicate whether an opioid is indicated.
What Pain Scale is Used for a 3-Year-Old?
One behavioral tool to assess pain is the FLACC scale, for children aged two to seven. It assesses a child's pain based on their facial expression, leg and arm movements, as well as the extent of crying and ability to be consoled.
How Do I Do the Pain Scale?
Start your assessments by asking patients to rate their pain on a scale from 0 to 10, with 10 being the worst possible pain and 0 being no pain. Get the answer to diagnostic questions like; Where are you feeling pain? When did the pain start? How long have you been in pain? And then recommend treatment options.
What are the 3 Different Types of Scales that are Used to Assess Pain?
They generally fall into one of three categories:
- Numerical rating scales (NRS): Use numbers to rate pain.
- Visual analog scales (VAS): Ask you to select a picture that best matches your pain level.
- Categorical scales: Primarily use words, possibly along with numbers, colors, or location(s) on the body.
What are the Most Common Pain Assessment Tools?
- Pain Assessment Scales
- FLACC Scale
- Numerical Rating Scale (NRS)
- Visual Analog Scale (VAS)
- Defense and Veterans Pain Rating Scale (DVPRS)
- Adult Non-Verbal Pain Scale (NVPS)
- Pain Assessment in Advanced Dementia Scale (PAINAD)
- Behavioral Pain Scale (BPS)
- Critical-Care Observation Tool (CPOT)
Additional resources and citations
- 1Voepel-Lewis T, Zanotti J, Dammeyer JA, Merkel S (2010). "Reliability and validity of the face, legs, activity, cry, consolability behavioral tool in assessing acute pain in critically ill patients". Am. J. Crit. Care. 19 (1): 55–61. doi:10.4037/ajcc2010624. PMID 20045849.
- 2https://en.wikipedia.org/wiki/FLACC_scale
- 3FLACC Scale Archived 2008-12-10 at the Wayback Machine (Extracted from The FLACC: A behavioral scale for scoring postoperative pain in young children, by S Merkel and others, 1997, Pediatr Nurse 23(3), p. 293–297)