Pain Assessment and Management, 2nd Edition _ _________________________________________________
SMILEY FACE PAIN RATING SCALE
Source: Pain scale vector clip art. https://publicdomainvectors.org/en/free-clipart/Pain-scale-vector-clip-art/26718.html
Figure 3
FLACC BEHAVIORAL PAIN ASSESSMENT SCALE
*Italic indicates the addition for the revised version: FLACC R. Categories 0
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Face
No particular expression or smile
Occasional grimace or frown, withdrawn, disoriented Appears sad or worried
Frequent to constant frown, quivering chin, clenched jaw Distressed-looking face; expression of fright or panic
Legs
Normal position or relaxed Usual tone and motion to limbs Lying quietly, normal position, moves easily Regular, rhythmic respirations
Uneasy, restless, tense Occasional tremors
Kicking or legs drawn up Marked increase in spasticity, constant tremors or jerking Arched, rigid, or jerking Severe agitation; head banging;
Activity
Squirming, shifting back and forth, tense Tense or guarded movements; mildly agitated (e.g., head back and forth, aggression); shallow, splinting respirations, intermittent sighs Moans or whimpers, occasional complaint Occasional verbal outburst or grunt Reassured by occasional touching, hugging, or being talked to, distractible
shivering (not rigors); breath holding, gasping or sharp intake of breaths, severe splinting
Cry
No cry (awake or asleep)
Crying steadily, screams or sobs, frequent complaints Repeated outbursts, constant grunting
Consolability Difficult to console or comfort Pushing away caregiver, resisting care or comfort measures Source: Original from Merkel et al, (1997). The FLACC: A behavioral scale for scoring postoperative pain in young children. Pediatric Nursing, 23(3), 293-297. Copyright 2002, The Regents of the University of Michigan. Used with permission. Revised version from Malviya et a (2006). The revised FLACC observational pain tool: Improved reliability and validity for pain assessment in children with cognitive impairment. Pediatric Anesthesia, 16(3), 258-265. https://doi-org.husson.idm.oclc.org/10.1111/j.1460-9592.2005.01773.x Figure 4 Content, relaxed
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