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

AB
Full NameFLACC Scale (Face, Legs, Activity, Cry, Consolability)
Purpose To assess pain in young children and individuals unable to communicate their pain verbally
Developed BySandra Merkel, MS, RN, and colleagues at the University of Michigan Health System
Year of Development 1997
ValidationValidated through various studies for reliability and effectiveness in different settings
Target GroupInfants and young children (typically 2 months to 7 years) or individuals who are non-verbal
Scoring Range0 to 10
ComponentsFive categories: Face, Legs, Activity, Cry, Consolability
Scoring MethodEach category is scored from 0 to 2, with 0 indicating no pain and 2 indicating severe pain
Interpretation0 = Relaxed and comfortable, 1-3 = Mild discomfort, 4-6 = Moderate pain, 7-10 = Severe discomfort/pain
Face0 = No particular expression or smile, 1 = Occasional grimace or frown, 2 = Frequent to constant frown
Legs0 = Normal position or relaxed, 1 = Uneasy, restless, tense, 2 = Kicking, or legs drawn up
Activity0 = Lying quietly, normal position, moves easily, 1 = Squirming, shifting back and forth, 2 = Arched, rigid, or jerking
Cry0 = No cry (awake or asleep), 1 = Moans or whimpers; occasional complaint, 2 = Crying steadily, screams or sobs, frequent complaints
Consolability0 = Content, relaxed, 1 = Reassured by occasional touching, hugging or talking to, distractible, 2 = Difficult to console or comfort
Use in Clinical SettingsCommonly used in pediatric settings, intensive care units, and post-operative care
AdvantagesSimple, quick, effective for non-verbal patients
LimitationsMay not be as accurate for chronic pain assessment, relies on observer's interpretation
Training RequiredMinimal; healthcare providers can quickly learn to use the scale
Revised VersionRevised-FLACC (r-FLACC) includes more detailed descriptors for each category to enhance accuracy
Application in Special PopulationAdapted for use in individuals with cognitive impairments, including dementia
Comparison with Other ScalesOften 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 UseDuring initial assessment, post-operative period, and regular intervals thereafter
AccessibilityWidely 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

Flacc Scale - Healthsoothe

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.

Behaviour012
FaceNo particular expression or smileOccasional grimace or frown, withdrawn, disinterestedFrequent to constant quivering chin, clenched jaw
LegsNormal position or relaxedUneasy, restless, tenseKicking or legs drawn up
ActivityLying quietly, normal position, moves easilySquirming, shifting, back and forth, tenseArched, rigid or jerking
CryNo cry (awake or asleep)Moans or whimpers; occasional complaintCrying steadily, screams, sobs, frequent complaints
ConsolabilityContent, relaxedReassured by touching, hugging or being talked to, distractibleDifficult 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.

All right, guys, that is it for now for flacc scale. I hope Healthsoothe answered any questions you had concerning the flacc pain scale.

Feel free to contact us at contact@healthsoothe.com if you have further questions to ask or if there’s anything you want to contribute or correct to this article. And don’t worry, Healthsoothe doesn’t bite.

You can always check our FAQs section below to know more about flacc scale. And always remember that Healthsoothe is one of the best health sites out there that genuinely cares for you. So, anytime, you need trustworthy answers to any of your health-related questions, come straight to us, and we will solve your problem(s) for you.

Frequently Asked Questions Related to the Flacc Scale

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.

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.

Infants and children aged 2 months to 18 years. Target populations include children with mild to severe cognitive impairments, developmental delay, and cerebral palsy.

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.

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.

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.

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.

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.

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.

 

  • 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)
Editorial Review Ratings
8.3
Excellent

Additional resources and citations

  • 1
    Voepel-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.
  • 2
    https://en.wikipedia.org/wiki/FLACC_scale
  • 3
    FLACC 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)
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