Clinical validation of FLACC: preverbal patient pain scale.
OBJECTIVE
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



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.


RESULTS
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.
Children's Medical Center of Dallas, Dallas, TX, USA.
Renee C B
RC
Manworren
Linda S
LS
Hynan
D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000494:pharmacology; D000704:Analysis of Variance; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D018730:Infant Behavior; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D009633:Nonverbal Communication; D015588:Observer Variation; D010147:Pain Measurement / Q000379:methods*; D015203:Reproducibility of Results; D015206:Southwestern United States
D000701:Analgesics, Opioid