FLACC vs. Wong-Baker FACES

[pyroknight, RN]

Does anyone NOT working in a HCA facility use the FACES scale to document the appearance of pain in adults (versus the patient's stated pain level or in non-communicative adults)? I am not talking about non-verbal patients who can point. I am talking about documenting how much pain a patient APPEARS to be in, versus the amount of pain they STATE they are in. Neither scale is ideal, but if I am not offered an adult non-communicative scale, the FLACC scale, to me, seems more appropriate than using FACES.

[Rhi007]

I volunteer for an ambulance and at events we use the Wong baker pain scale with kids...

[chare]

I'm not sure that I understand your question. If you are referring to an awake patient with the ability to self-report, why aren't you accepting their report?

[WSU_Ally_RN, BSN, RN]

The faces scale isn't for you to interpret what their pain APPEARS to be, it's for you to show your patient and have them pick how their face feels with their pain... I use this all the time with my preschoolers, I show them the scale and they point to their pain. With an adult that is able to communicate with you, you should always be using the #'s scale, and what ever they say their pain is, it is, no matter what you think it is!

[chrisrn24]

The faces scale isn't for you to interpret what their pain APPEARS to be it's for you to show your patient and have them pick how their face feels with their pain... I use is all the time with my preschoolers, I show them the scale and they point to their pain. With an adult that is able to communicate with you, you should always be using the #'s scale, and what ever they say their pain is, it is, no matter what you think it is![/quote']

Exactly.

To me there's nothing wrong with documenting "patient reports pain 10/10, is grimacing" or "patient reports pain 10/10, is sitting at bedside laughing with family members and eating lunch."

[LadyFree28, BSN, LPN, RN]

FACES is usually the default option when working in Pediatric pediatric patients who are able to point out how they feel to assign a quantitative number to the pain. FLACC is utilized for non-verbal children and adults-however, If ones face exhibits the expression of such pain after appropriately assessing the patient further, then if one were to use the faces scale, it would be appropriate in that context; however, if one could self report, then FLACC scale can be a resource in the assessment, but not a defining factor due to self reporting.

[lmccrn62, MSN, RN]

Faces is used for patients that can communicate. They are instructed to pick the face that represents how much pain they are feeling. FLACC is a behavioral tool to be used in patients that are unable to verbalized their pain. The number you get from FLACC does not mean their pain is that number but it may indicate they might have pain. You also use your assessment skills and critical thinking such as this patient has a hip fracture, or they have history of chronic pain, etc. never use FLACC for a sleeping patient it's only for those that are cognitively impaired.

[Altra, BSN, RN]

Agree with the above posters - the two scales are not interchangeable. FACES is a self-reporting system, whereas FLACC is a metric for your assessment.