Wong Baker Faces Pain Scale


Wong Baker Faces Pain Scale
Face 1 hurts just a little bit. Face 2 hurts a little more. Face 3 hurts even more. Face 4 hurts a whole lot more.

What age is Wong-Baker Faces Pain Scale for?

The Wong-Baker Faces Pain Scale can be confidently used by children as young as 3 years old. It is assumed that children at this age should be able to distinguish fascial expressions related to pain, and identify the severity.

Is the Wong-Baker FACES Pain Rating Scale reliable?

Faces Pain Scales – Faces pain scales comprise a series of line diagrams of faces with expressions of increasing distress.22–27 Some versions have a smiling face whereas others have a neutral face to represent the “no pain” end of the scale ( Fig.44-1 ).

What is Wong-Baker pain scale 8?

Face 4 hurts a little bit more. Face 6 hurts even more. Face 8 hurt a whole lot. Face 10 hurts as much as you can imagine, although you don’t have to be crying to have this worst pain.

What is the 5 faces pain scale?

The Faces Pain Scale – Revised (FPS-R) is a self-report measure of pain intensity developed for children. – – Revised (FPS-R) is a self-report measure of pain intensity developed for children. It was adapted from the Faces Pain Scale to make it possible to score the sensation of pain on the widely accepted 0-to-10 metric.

  • The scale shows a close linear relationship with visual analog pain scales across the age range of 4-16 years.
  • It is easy to administer and requires no equipment except for the photocopied faces.
  • The absence of smiles and tears in this scale may be advantageous.
  • It is particularly recommended for use with very young children.

Numerical self-rating scales (0-10) can be used with most children older than 8 years of age, and behavioral observation scales are required for those unable to provide a self-report. Faces Pain Scale – Revised, ©2001, International Association for the Study of Pain In the following instructions, say “Hurt” or “Pain,” whichever seems right for a particular child: “These faces show how much something can hurt. This face shows no pain.

The faces show more and more pain up to this one. It shows very much pain. Point to the face that shows how much you hurt,” Score the chosen face 0, 2, 4, 6, 8, or 10, counting left to right, so “0” equals “No pain” and “10” equals “Very much pain.” Do not use words like “happy” and ‘”sad.” This scale is intended to measure how children feel inside, not how their face looks.

For clinical, educational, or research purposes, use of the FPS-R is free of charge, and permission for use is not needed, provided that the scale is not modified or altered in any way, Please, For reproduction of the FPS-R in a journal, book, or web page or for any commercial use of the scale, request permission here:,

What pain scale is used for a 10 year old?

Numeric Rating Scale (NRS) 0-10 – This scale is normally used for children over eight years old. We ask your child to rate their pain from no pain to the worst possible pain. Sometimes, many factors can go into choosing that number. These may include:

  • Fear
  • Concern that someone will cause more pain
  • Belief that no one believes them
  • Stress of being in the hospital
  • Being away from loved ones

If, at any age, you think your child cannot use this scale, it is ok to use the Pain Faces Scale Revised. Let your child’s nurse know if a pain scale is not working so they can make a change. The pain scale is just a tool to help us talk with you and your child about your child’s pain. : Patients & Families | UW Health

What is the most effective pain scale?

Numerical Rating Pain Scale – NIH / Warren Grant Magnusen Clinical Center The Numerical Rating Scale (NRS) is designed for anyone over age 9. It is one of the most commonly used pain scales in health care. To use it, you just say the number that best matches the level of pain you are feeling; you can also place a mark on the scale itself.

What are the disadvantages of the Wong-Baker Faces Pain Scale?

Is the scale suitable for everyone? – The scale is unsuitable for assessing pain in unresponsive people. It is also not suitable for those under 3 years of age. Furthermore, as a person must understand how to use the scale, older research suggests it may not be appropriate for those with severe cognitive impairments.

Which is the most accurate type of pain scale?

Visual analog scale – Visual analog scales can vary in appearance. Some are simple lines with “no pain” at one end and “severe pain” at the other. People mark a point between those extremes to demonstrate how much pain they are experiencing. One of the benefits of visual analog scales is that people can express their precise pain level.

  • This can be useful for people who have long-term conditions with pain levels that vary over time.
  • Visual analog scales are more sensitive tools for researchers, and less prone to bias.
  • According to a 2017 paper, studies suggest they are reliable and accurate.
  • However, it can be difficult for people to rate their pain on these scales without labels or descriptors, particularly if they have cognitive impairments.
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Healthcare professionals may also struggle to interpret the results.

Is there a real pain scale?

Numeric rating scales (NRS) – This pain scale is most commonly used. A person rates their pain on a scale of 0 to 10 or 0 to 5. Zero means “no pain,” and 5 or 10 means “the worst possible pain.” These pain intensity levels may be assessed upon initial treatment, or periodically after treatment.

How bad is the pain scale?

What Is a Pain Scale? – A pain scale is simply a way of rating or quantifying your pain so you can talk about it with your doctor, other health care professionals, or even your friends and family. There are many different kinds of pain scales, but a common one is a numerical scale from 0 to 10.

  1. Here, 0 means you have no pain; one to three means mild pain; four to seven is considered moderate pain; eight and above is severe pain.
  2. Pain scales are based on self-reported data — that means from you, the patient — so they are admittedly subjective.
  3. Your version of a seven could be someone else’s idea of a three.

But the idea is that they can help compare your own ratings over time. Is your pain improving or getting worse? Using a pain scale can also help you and your doctor analyze which factors — a change in physical activity, say, or a new medication regimen — could be responsible for those changes.

Can you use faces pain scale for adults?

FACES Pain Scale Revised (FPS-R) – Pain intensity rating scale useful for all older adults, including those with mild to moderate cognitive impairment. Some older adults will find this tool easy to use, and may prefer it over the Numerical Rating Scale. This scale requires either verbal ability or the ability to point to the image on the scale that most closely represents their pain.

Is the faces pain scale revised as compared to Wong Baker?

The FACES pain scale has been revised so that the scale is from zero to ten rather than zero to five as in the Wong- Baker measure or zero to six as in the Bieri Faces Pain scale (not shown). The affective qualities including the smile and tears have been removed.

What is the pain scale for autism?

Research on autism and pain Not much research has been done on the topic of autism and pain, partly due to the challenges of assessing pain in children with communication difficulty and partly due to the common belief that people with autism have decreased sensitivity to pain or a high pain threshold.

Studies conducted with people with high-functioning ASD tend to use a pain scale of 0-10. On this scale, patients tend to respond with lower numbers, but other methods of rating pain have shown varying results. Some studies have used observations of providers or parents, which also tended to show decreased sensitivity to pain in children with autism.

Other studies have challenged the idea that people with autism experience less pain. These studies found that pain is expressed differently among those with autism. One study comparing children with autism, children with intellectual disabilities, and neurotypical children showed that both behavioral changes and physiologic changes (i.e.

heart rate) were higher with pain, but face scores did not vary among the groups. Some case studies have found that when asked their pain score, verbal individuals with ASD respond with low scores, but when asked how much discomfort they have, the score tends to be higher. How does pain manifest in children with autism? Children with ASD may not express pain in typical ways – crying, moaning, or withdrawing from a painful stimulus – and therefore may often be labeled as less sensitive to pain.

Several case studies have shown that though children may not show these typical signs or may not react to pain in the moment, they still have physiologic reactions and behavioral reactions. Even with no obvious reaction to a painful stimulus, they may start breathing fast or their heart rate may increase.

They may have increased stimming behaviors, aggression, or anxiety after the painful incident. Individuals with ASD also tend to show behavior changes for longer after the painful incident than neurotypical children or children with intellectual disabilities. When assessing for pain in a nonverbal child with ASD, close attention should be paid to increased aggression, self-injurious behaviors, stimming, or any behavior that is not typical for that child.

If they are acting unlike themselves, look for a possible source of discomfort or pain that may be present or was present in the near past. In a more verbal child, asking if they have pain or if something hurts may not accurately reflect what they are feeling.

  • Using words such as “discomfort”, “uncomfortable”, or “anxiety” may better approximate the level of pain they are in.
  • What can I do about my child’s pain? If a source of pain can be identified, treating that pain is of utmost importance.
  • Treatment would be the same as for any other child—analgesics such as Tylenol or ibuprofen, ice, or heat (if tolerated), and rest.
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Parents and providers should be wary of hidden injuries that the patient may not be able to communicate about, such as a fracture or insect bite. If the source of pain cannot be identified or you are unsure of the severity of the injury/illness, always err on the side of caution and have a physician assess your child.

  1. They should do a full skin exam to look for scratches, bites, rashes, or other injuries.
  2. If an injury is suspected to a limb, x-rays may be needed to rule out a fracture.
  3. If no clear injury or illness can be identified, parents and providers should look for other possible medical causes for the behavior changes, like abdominal pain, headache, or urinary tract infection.

For pain management during painful or stress-inducing medical procedures, like a blood draw, there are several techniques that can be used. Non-pharmacologic (medication) methods are preferred. Every child may respond differently to these techniques, so some trial and error may be necessary to determine the best method for your child.

• Distraction: If your child has a preferred activity, engaging them in this activity during the procedure may significantly reduce their focus on pain. This could include watching a show, blowing bubbles, deep breaths, playing with a toy, or calming movements such as a parent rocking them. • Sensory distractions: There are several items that can be used to distract a child’s senses from the painful stimulus.

A vibrating device or ice placed on the area of a blood draw or lumbar puncture can reduce the pain signal sent to the brain. • Topical pain control: There are a few topical medications that can be used to reduce pain sensation. A cooling spray at the site of the procedure is quick and easy.

A numbing gel or cream can also be applied 20-30 minutes prior to the procedure, which has been shown to be an effective way to manage pain during IV sticks. However, this has not been shown to reduce anxiety or fear during procedures. • Deep pressure: Firm pressure, through squeezing or a tight hug, has been shown to significantly decrease anxiety and stress in individuals with autism.

This method can also be used during medical procedures to decrease discomfort. Every child is different though, so deep pressure may be too much sensory stimulation for some. Medications can also be used to control pain, as well as anxiety, during medical procedures.

Pre-medication with acetaminophen or ibuprofen may be helpful in reducing pain. For extremely painful procedures, an opioid may also be reasonable, per a physician’s assessment. Anti-anxiety medications may be helpful in reducing not only anxiety but also pain as they are typically slightly sedating. If you feel it is right for your child, discuss these options with your physician.

When it comes to pain management in autism, remember these key points: • Always rule out pain when atypical behaviors occur or when certain behaviors increase. • Children are all different, whether in how their pain manifests or in what strategies work best to control their pain.

Is pain scale 0-10?

Most pain scales use numbers from 0 to 10. A score of 0 means no pain, and 10 means the worst pain you have ever felt.

What pain assessment tool for 7 year old?

Pediatric Fast Facts and Concepts #2 Background Neonates and infants do experience pain. In fact, research has shown that neonates may experience as much pain as older children and long-term consequences from exposure to repeated painful stimuli. Untreated pain leads to increased sensitivity to subsequent stimuli. Assessing pain in neonates and young children requires use of age appropriate scales. There is no empirical evidence demonstrating the superiority of one assessment tool, but research suggests that the same scale(s) should be used within an institution. Behavioral Observational Scales: The primary method of pain assessment for infants, children less than 3 yrs old, and developmentally disabled patients. Validated tools include: CRIES: Assesses Crying, Oxygen requirement, Increased vital signs, facial Expression, Sleep. An observer provides a score of 0-2 for each parameter based on changes from baseline. For example, a grimace, the facial expression most often associated with pain, gains a score of 1 but if associated with a grunt will be scored a 2. The scale is useful for neonatal postoperative pain. NIPS: Neonatal/Infants Pain Scale has been used mostly in infants less than 1 yr of age. Facial expression, cry, breathing pattern, arms, legs, and state of arousal are observed for 1 minute intervals before, during, and after a procedure and a numeric score is assigned to each. A score >3 indicates pain. An example is available at: http://www.anes.ucla.edu/pain/assessment_tool-nips.htm. FLACC: Face, Legs, Activity, Crying, Consolability scale has been validated from 2 mo to 7 years. FLACC uses 0-10 scoring. An example is available at: http://www.anes.ucla.edu/pain/assessment_tool-flacc.htm. CHEOPS: Children’s Hospital of Eastern Ontario Scale. Intended for children 1-7 yrs old. Assesses cry, facial expression, verbalization, torso movement, if child touches affected site, and position of legs. A score >/= 4 signifies pain. An example is available at: http://www.anes.ucla.edu/pain/assessment_tool-cheops.htm. Self report: Children 3 years of age and older can rank their pain using one of several validated scales including: Wong-Baker Faces scale : 6 cartoon faces showing increasing degrees of distress. Face 0 signifies “no hurt” and face 5 the “worst hurt you can imagine.” The child chooses the face that best describes pain at the time of assessment. An example is available at: http://www1.us.elsevierhealth.com/FACES/. Bieri-Modified: 6 cartoon faces starting from a neutral state and progressing to tears/crying. Scored 0-10 by the child. Used for children >3 years. Visual analogue scale : Uses a 10 cm line with one end marked as no pain and the opposite end marked as the worst pain. The child is asked to make a mark on that line that is then measured in cm from the no pain end. Parent or Caregiver Report: INRS : Individualized Numeric Rating Scale. This is a validated pain assessment tool for nonverbal children with intellectual disability. Essentially, it is an adaptation of the numeric rating scale that incorporates the parents’ and/or caregiver’s descriptions of the child’s past and current responses to pain. Once described, the responses are then stratified on a scale from 0 to 10. References

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Hockenberry M, Wilson D, et al. Wong’s Nursing Care of Infants and Children.7th Edition. St Louis, MO: Mosby; 2003: pp1052-1053. Berde CB, Sethna NF. Analgesics for the treatment of pain in children. N Engl J Med.2002; 347:1094-1101. Zempsky WT, Schechter, NL. What’s new in the management of pain in children. Pediatrics in Review.2003; 24:337-347. Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S. The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr Nurs.1997; 3(3):293-7. Hicks CL, von Baeyer CL, Spafford PA, et al. The Faces Pain Scale-Revised: toward a common metric in pediatric pain measurement. Pain.2001; 93(2):173-83. Cancer Pain Management in Children (web-site). Texas Cancer Council. Available at: http://www.childcancerpain.org. Solodiuk J, Curley MA. Pain assessment in nonverbal children with severe cognitive impairments: the Individualized Numeric Rating Scale (INRS). J Pediatr Nurs 2003; 18:295-299. Solodiuk JC, Scott-Sutherland J, et al. Validation of the Individualized Numeric Rating Scale (INRS): a pain assessment tool for nonverbal children with intellectual disability. Pain 2010; 150:231-236.

Version History: This Fast Fact was originally edited by David E Weissman MD and published in June 2004. Re-copy-edited in April 2009; web-sites updated; revised again in July 2015 by Sarah Friebert MD. Fast Facts and Concepts are edited by Sean Marks MD (Medical College of Wisconsin) and associate editor Drew A Rosielle MD (University of Minnesota Medical School), with the generous support of a volunteer peer-review editorial board, and are made available online by the Palliative Care Network of Wisconsin (PCNOW); the authors of each individual Fast Fact are solely responsible for that Fast Fact’s content.

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What is the Wong Baker scale for children?

The Wong-Baker FACES Pain Rating Scale has been widely used to obtain a self-report of pain from children as young as 3 years old. The scale consists of six faces assigned a rating from 0 to 5, with 0 equaling no pain and 5 the most intense pain.

What pain scale is for 9 years and older?

Interpreting the score

0 = Relaxed and comfortable
1–3 = Mild discomfort
4–6 = Moderate pain
7–10 = Severe pain or discomfort or both

Who can use the Wong-Baker pain scale?

Is the scale suitable for everyone? – The scale is unsuitable for assessing pain in unresponsive people. It is also not suitable for those under 3 years of age. Furthermore, as a person must understand how to use the scale, older research suggests it may not be appropriate for those with severe cognitive impairments.

Who is the Wong and Baker faces pain rating scale best use for?

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Developed for young patients to communicate how much pain they are feeling. D

What ages can use FLACC scale?

Target Population: – Infants and children aged 2 months to 18 years. Target populations include children with mild to severe cognitive impairments, developmental delay, and cerebral palsy. (, ) Values are also used to interpret postoperative pain in children with mild to severe cognitive impairments, and pain secondary to trauma, surgery, cancer, and other diseases in preverbal children (, ).

What age is behavioral pain scale for?

From Wikipedia, the free encyclopedia

FLACC scale
Synonyms Face, Legs, Activity, Cry, Consolability scale
Purpose used to assess pain in children

The FLACC scale or Face, Legs, Activity, Cry, Consolability scale is a measurement used to assess pain for children between the ages of 2 months and 7 years or individuals that are unable to communicate their pain. The scale is scored in a range of 0–10 with 0 representing no pain. The scale has five criteria, which are each assigned a score of 0, 1 or 2.

Criteria Score 0 Score 1 Score 2
Face No particular expression or smile Occasional grimace or frown, withdrawn, uninterested Frequent to constant quivering chin, clenched jaw
Legs Normal position or relaxed Uneasy, restless, tense Kicking, or legs drawn up
Activity Lying quietly, normal position, moves easily Squirming, shifting, back and forth, tense Arched, rigid or jerking
Cry No cry (awake or asleep) Moans or whimpers; occasional complaint Crying steadily, screams or sobs, frequent complaints
Consolability Content, relaxed Reassured by occasional touching, hugging or being talked to, distractible Difficult to console or comfort

The FLACC scale has also been found to be accurate for use with adults in intensive-care units (ICU) who are unable to speak due to intubation, The FLACC scale offered the same evaluation of pain as did the Checklist of Nonverbal Pain Indicators (CNPI) scale which is used in ICUs.