Which items are included in the FLACC scale?

• A. Facial grimace, leg movement, activity, crying, consolability
• B. Facial expression, lip color, breathing, body color
• C. Heart rate, respiratory rate, blood pressure, temperature
• D. Alertness, irritability, appetite, sleep

Answer: (A)

FLACC is a pain assessment tool for nonverbal or very young patients that relies on observable behaviors to gauge discomfort. The five items it measures are facial expression, leg movement, activity, crying, and consolability. Each item is scored 0 to 2, and the scores are added to give a total pain score from 0 to 10. This set of behaviors specifically captures how pain presents when a child cannot clearly communicate it, making it the best fit for assessing discomfort in these patients.

These domains reflect outward, interpretable cues: facial expressions like grimacing, leg movement or restlessness, overall activity level, crying intensity, and how easily the child can be consoled. This focus on observable behavior is what makes FLACC different from scales that rely on physiological measures (like heart rate or blood pressure) or broader mood indicators (like sleep or appetite), which can be influenced by many factors other than pain.