Introduction
The FLACC Scale is a behavioral scale for scoring pain in children between the ages of two months and seven years or in patients unable to communicate. FLACC acronym stands for face, legs, activity, crying, and consolability, the areas observed during the assessment, each scored with 0 to 2 points.
The scale was developed by the Department of Anesthesiology, University of Michigan Medical School and Health Systems and can also be used for pain evaluation in intubated patients.
Use the following EVALUATION FORM to evaluate your patient and PRINT THE FORM when the evaluation is completed.
Scoring
There are two sets of instructions for the observers, depending on whether the patients are awake or asleep during evaluation.
For patients who are awake:
- Observe for at least 2-5 minutes.
- Observe legs and body uncovered.
- Reposition patient or observe activity; assess body for tenseness and tone.
- Initiate consoling interventions if needed.
For patients who are asleep:
- Observe for at least 5 minutes or longer.
- Observe body and legs uncovered.
- If possible reposition the patient.
- Touch the body and assess for tenseness and tone.
The FLACC scores range from 0 to 10 and are interpreted as follows:
0: Relaxed and comfortable1 – 3: Mild discomfort4 – 6: Moderate pain7 – 10: Severe discomfort/pain
References
Original reference
Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S. The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr Nurs. 1997 May-Jun;23(3):293-7.
Validation
Voepel-Lewis T, Zanotti J, Dammeyer JA, Merkel S. Reliability and Validity of the Face, Legs, Activity, Cry, Consolability Behavioral Tool in Assessing Acute Pain in Critically Ill Patients. Am J Crit Care. 2010 Jan;19(1):55-61; quiz 62.
Other references
Crellin DJ, Harrison D, Santamaria N, Huque H, Babl FE. The Psychometric Properties of the FLACC Scale Used to Assess Procedural Pain. J Pain. 2018 Aug;19(8):862-872.