The FLACC: a behavioral scale for scoring postoperative pain in young children.
OBJECTIVE
To evaluate the reliability and validity of the FLACC Pain Assessment Tool which incorporates five categories of pain behaviors: facial expression; leg movement; activity; cry; and consolability.


METHODS
Eighty-nine children aged 2 months to 7 years, (3.0 +/- 2.0 yrs.) who had undergone a variety of surgical procedures, were observed in the Post Anesthesia Care Unit (PACU). The study consisted of: 1) measuring interrater reliability; 2) testing validity by measuring changes in FLACC scores in response to administration of analgesics; and 3) comparing FLACC scores to other pain ratings.


RESULTS
The FLACC tool was found to have high interrater reliability. Preliminary evidence of validity was provided by the significant decrease in FLACC scores related to administration of analgesics. Validity was also supported by the correlation with scores assigned by the Objective Pain Scale (OPS) and nurses' global ratings of pain.


CONCLUSIONS
The FLACC provides a simple framework for quantifying pain behaviors in children who may not be able to verbalize the presence or severity of pain. Our preliminary data indicates the FLACC pain assessment tool is valid and reliable.
Merkel
S I
SI
Department of Anesthesiology, University of Michigan Medical School and Health Systems, Ann Arbor, USA.
Voepel-Lewis
T
T
Shayevitz
J R
JR
Malviya
S
S
D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009730:Nursing Assessment; D010147:Pain Measurement / Q000592:standards*; D010149:Postoperative Pain / Q000175:diagnosis* / Q000523:psychology*; D010371:Pediatric Nursing; D015203:Reproducibility of Results; D012720:Severity of Illness Index