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FLACC Pain Scale

Observational pain score for children aged 2 months-7 years, or any child unable to self-report.

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1 What is the FLACC Pain Scale?

The FLACC Pain Scale is a pain scoring tool used in paediatric practice. Observational pain score for children aged 2 months-7 years, or any child unable to self-report. It scores 5 criteria and interprets the total across 4 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.

2 When to use it

  • Grading severity at the bedside in pain
  • Recording an objective severity band in the case notes
  • Deciding when a total crosses the threshold for escalation
  • Re-scoring to track whether a child is improving or deteriorating
  • Checking the exact criteria of a score used infrequently

3 Formula & method

The score sums 5 criteria: Face; Legs; Activity; Cry; Consolability. Totals are then banded: any score - No pain: fLACC 0 - relaxed and comfortable; 1 point or more - Mild discomfort: fLACC 1-3 - mild discomfort. Non-pharmacological comfort measures; reassess; 4 points or more - Moderate pain: fLACC 4-6 - moderate pain. Give analgesia and reassess within 30 minutes; 7 points or more - Severe pain: fLACC 7-10 - severe discomfort/pain. Give prompt analgesia (consider opioid) and reassess frequently.
  • Total range 0-10. A revised FLACC exists for children with cognitive impairment.
  • Source: Merkel SI et al. The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr Nurs 1997;23:293-7.

4 Frequently asked questions

How many criteria does the FLACC Pain Scale use?

5. They are Face; Legs; Activity; Cry; Consolability.

What do the bands of the FLACC Pain Scale mean?

The total is interpreted as: any score - No pain: fLACC 0 - relaxed and comfortable; 1 point or more - Mild discomfort: fLACC 1-3 - mild discomfort. Non-pharmacological comfort measures; reassess; 4 points or more - Moderate pain: fLACC 4-6 - moderate pain. Give analgesia and reassess within 30 minutes; 7 points or more - Severe pain: fLACC 7-10 - severe discomfort/pain. Give prompt analgesia (consider opioid) and reassess frequently.

Does the score replace clinical judgement?

No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.

Where does this score come from?

Total range 0-10. A revised FLACC exists for children with cognitive impairment.

Does it work offline?

Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.

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For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.