Back to Search
Start Over
The Use of the Faces, Legs, Activity, Cry and Consolability Scale to Assess Procedural Pain and Distress in Young Children
- Source :
- Pediatric Emergency Care. 28:1281-1296
- Publication Year :
- 2012
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2012.
-
Abstract
- Young children frequently undergo diagnostic and therapeutic procedures in the emergency department (ED). Although developed and validated for postoperative pain, Face, Legs, Activity, Cry, Consolability (FLACC) behavioral pain scores have been recommended and used for the assessment of procedural pain as well. We set out to assess if FLACC scores can differentiate pain and distress and establish a hierarchy of FLACC scores experienced during common ED procedures.Prospective observational study at an urban tertiary children's hospital ED. We aimed to recruit 30 children each aged 6 to 42 months undergoing intravenous cannula (IV) insertion, nasogastric tube (NGT) insertion, metered dose inhaler (MDI) use and oxygen saturation (SpO(2)) measurement. Based on videotapes, 2 independent observers assessed pain and distress using FLACC scores during all procedural phases.A total of 125 patients were recruited and filmed for IV (33), NGT (30), MDI (34), and SpO2 (28). Median FLACC scores were as follows: NGT, 10 (interquartile range [IQR] 8.75-10); IV, 6.5 (IQR, 4.5-9.75); MDI, 6.5 (IQR, 0-9); and SpO(2), 0 (IQR, 0-0.5). The FLACC scores increased during each of the 3 phases, before the procedure, during restraint, and during the procedure. Procedural distress decreased with age except for NGT insertions, which remained very high irrespective of age.FLACC scores can be high during nonpainful procedures and the during restraint phase of painful procedures. This indicates that FLACC measures a composite of pain and distress in young children. This study identified substantial levels of pain and distress in young children by FLACC during commonly performed ED procedures, with nasogastric tube insertion having very high and intravenous cannulation/venepuncture and MDI having high FLACC scores.
- Subjects :
- Male
Restraint, Physical
medicine.medical_specialty
Movement
Postoperative pain
Child Behavior
Pain
Crying
Motor Activity
Propofol sedation
Catheterization
Phlebotomy
medicine
Humans
Metered Dose Inhalers
Oximetry
Prospective Studies
Intubation, Gastrointestinal
Pain Measurement
Leg
business.industry
Age Factors
Chronic pain
Facies
Infant
Videotape Recording
General Medicine
Emergency department
medicine.disease
Procedural Pain
Distress
Child, Preschool
Infant Behavior
Pediatrics, Perinatology and Child Health
FLACC scale
Emergency Medicine
Physical therapy
Female
medicine.symptom
Emergency Service, Hospital
business
Subjects
Details
- ISSN :
- 07495161
- Volume :
- 28
- Database :
- OpenAIRE
- Journal :
- Pediatric Emergency Care
- Accession number :
- edsair.doi.dedup.....dc99b690ba7a5976ac228bb23b8c02c0