Pain Scales - Valuable Pain Assessment Tools

The Wong Baker Faces Pain Scale combines pictures and numbers to allow pain to be rated by the user. It can be used in children over the age of 3, and in adults. The faces range from a smiling face to a sad, crying face. A numerical rating is assigned to each face, of which there are 6 total.

Perhaps one of the most commonly used pain scales in healthcare, the numerical rating scale offers the individual in pain to rate their pain score. It is designed to be used by those over the age of 9. In the numerical scale, the user has the option to verbally rate their scale from 0 to 10 or to place a mark on a line indicating their level of pain. 0 indictates the absence of pain, while 10 represents the most intense pain possible.

The Numerical Rating Pain Scale allows the healthcare provider to rate pain as mild, moderate or severe, which can indicate a potential disability level.

FLACC stands for face, legs, activity, crying and consolability. The FLACC pain scale was developed to help medical observers to assess the level of pain in children who are too young to cooperate verbally. It an also be used in adults who are unable to communicate.

The FLACC scale is based on observations made regarding the patient’s face, the position of their legs, their actions, and whether they are calm or consolable. Zero to two points are assigned for each of these 5 areas of observation.

The overall score is recorded as follows:

0 = Relaxed and comfortable

1-3 = Mild discomfort

4-6 = Moderate pain

7-10 = Severe discomfort/pain

By recording the FLACC score periodically, the medical personnel can gain some sense of whether the patient’s pain is increasing, decreasing or stable.

The CRIES Pain Scale is often used in the neonatal healthcare setting. CRIES is an observer-rated pain assessment tool which is performed by a healthcare practitioner such as a nurse or physician. CRIES assesses crying, oxygenation, vital signs, facial expression, and sleeplessness. The CRIES Pain Scale is generally used for infants 6 months old and younger.

The COMFORT Scale is a pain scale that may be used by a healthcare provider when a person cannot describe or rate their pain. Some of the common populations this scale might be used with include:

• children
• cognitively impaired adults
• adults whose cognition is temporarily impaired, by medication or illness
• the learning disabled
• sedated patients in an ICU or operating room setting

The COMFORT Scale provides a pain rating between 9 and 45.

The McGill Pain Questionnaire consists of groupings of words that describe pain. The person rating their pain ranks the words in each grouping. Some examples of the words used are tugging, sharp and wretched.

Once the person has rated their pain words, the administrator assigns a numerical score, called the Pain Rating Index.