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Clinical validation of FLACC: preverbal patient pain scale
Renee C B Manworren1, Linda S Hynan
1Children's Medical Center of Dallas, Dallas, TX, USA.
Insights
The Faces, Legs, Activity, Cry and Consolability (FLACC) scale effectively assesses pain in young children. Scores decreased significantly after analgesia, confirming its validity for pediatric pain management.
Area of Science:
- Pediatric Nursing
- Pain Management
- Clinical Assessment Tools
Background:
- Accurate pain assessment in preverbal children is challenging.
- The Faces, Legs, Activity, Cry and Consolability (FLACC) scale is an observational tool designed for this population.
- Validating pain assessment tools is crucial for effective treatment.
Purpose of the Study:
- To evaluate the validity of the FLACC pain assessment tool.
- To measure changes in FLACC scores following analgesic administration in pediatric patients.
- To determine if FLACC scores can guide analgesic selection.
Main Methods:
- Pediatric nurses assessed pain in 147 children under 3 years using the FLACC scale.
- Measurements were taken pre-analgesia, at predicted onset, and peak analgesia.
- FLACC scores range from 0-10, based on facial expression, leg movement, activity, cry, and consolability.
Main Results:
- Pre-analgesia FLACC scores were significantly higher than post-analgesic scores.
- Patients receiving opioids had higher initial FLACC scores than those receiving non-opioids.
- Peak analgesia FLACC scores were not significantly different across groups, indicating effective pain relief.
Conclusions:
- The FLACC pain assessment tool is appropriate for preverbal children experiencing pain.
- The study supports using clinical judgment for analgesic choice over specific FLACC scores.
- FLACC is a valid tool for assessing pain in hospitalized pediatric patients.
Purpose:
To test the validity of the Faces, Legs, Activity, Cry and Consolability (FLACC) pain assessment tool by measuring changes in scores in response to analgesics.
Methods:
Pediatric nurses used the FLACC scale to assess pain in 147 children under 3 years of age who were hospitalized in the pediatric intensive care unit (PICU), post-anesthesia care unit (PACU), surgical/trauma unit, hematology/oncology unit, or infant unit. FLACC is an observational tool for quantifying pain behaviors. Facial expression, leg movement, activity, cry, and consolability are each scored 0-2, for a total FLACC score of 0-10. The FLACC measurements were done pre-analgesia, at predicted onset of analgesia, and at predicted peak analgesia.
Findings:
Pre-analgesia FLACC scores were significantly higher than post-analgesic scores and significantly higher for patients who received opioids than patients who received non-opioids. Peak analgesia FLACC scores across analgesia groups were not significantly different and reflect effective pain relief for patients regardless of analgesic choice.
Conclusions:
The FLACC pain assessment tool is appropriate for preverbal children in pain from surgery, trauma, cancer, or other disease processes. The results support pediatric nurses' clinical judgment to determine analgesic choice rather than providing distinct FLACC scores to guide analgesic selection.
