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Revised FLACC pain score

Revised FLACC pain score
Categories Scoring
0 1 2

F

Face

No particular expression or smile Occasional grimace or frown, withdrawn, disinterested; appears sad or worried Frequent to constant frown, clenched jaw, quivering chin; distressed-looking face: expression of fright or panic

L

Legs

Normal position or relaxed Uneasy, restless, tense; occasional tremors Kicking or legs drawn up; marked increase in spasticity, constant tremors or jerking

A

Activity

Lying quietly, normal position, moves easily Squirming, shifting back and forth, tense; mildly agitated (eg, head back and forth, aggression); shallow and splinting respirations, intermittent sighs Arched, rigid, or jerking; severe agitation, head banging; shivering (not rigors); breath-holding, gasping or sharp intake of breath; severe splinting

C

Cry

No cry (awake or asleep) Moans or whimpers, occasional complaint; occasional verbal outburst or grunt Crying steadily, screams or sobs, frequent complaints; repeated outbursts, constant grunting

C

Consolability

Content, relaxed Reassured by occasional touching, hugging, or being talked to, distractable Difficult to console or comfort; pushing away caregiver, resisting care or comfort measures
This pain score can be used to assess pain from burns and other etiologies for preverbal children.
  • Each of the five categories, (F) Face, (L) Legs, (A) Activity, (C) Cry, (C) Consolability, is scored from 0 to 2, which results in a total score between 0 and 10.
  • Patients who are awake – Observe for at least 1 to 2 minutes. Observe legs and body uncovered. Reposition patient or observe activity; assess body for tenseness and tone. Initiate consoling interventions if needed.
  • Patients who are asleep – Observe for at least 2 minutes or longer. Observe body and legs uncovered. If possible, reposition the patient. Touch the body and assess for tenseness and tone.
  • The revised FLACC can be used for children with cognitive disability. The additional descriptors (in italics) are included with the original FLACC. The nurse can review the descriptors within each category with parents. Ask them if there are additional behaviors that are better indicators of pain in their child. Add these behaviors to the tool in the appropriate category.
Reproduced with permission. Copyright © 2002 The Regents of the University of Michigan.
Graphic 81819 Version 3.0