Of the following, which is the MOST RELIABLE measure of pain in a 10 yearold pediatric patient.
a) The Faces scale
b) The FLACC scale
c) Crying and other behavioral markers
d) Vital signs assessment
e) Parental report of patient discomfort
Answer a. Because pain is a subjective experience, self-reporting tools tend to be superior when feasible. A score of 7/10 for one patient may not be comparable to a score of 7/10 in a different patient, but can be compared to different pain scores in the same patient. Behavioral and physiologic parameters, as well as parental reports of comfort/discomfort, provide data to be taken into consideration in the management strategy, but are probably inferior to self-reported data. The FLACC scale is used for younger children, whereas the Faces scale is appropriate for this patient.