Measuring Pain in Kids: Comparing FLACC, MBPS & VASobs

Understanding Pain in Our Little Ones: Why Measuring Pain Matters

As moms, it’s heartbreaking to see our babies or young children in pain, especially during medical procedures. It’s important for doctors and nurses to understand just how much pain our little ones are feeling so they can provide the best care possible.

However, babies and young children can’t tell us exactly how much pain they’re experiencing, like we can. This is where special pain scales come in. These scales help doctors and nurses understand and measure pain in infants and young children by observing their behaviors.

There are many different pain scales available, but not all of them are reliable or suitable for measuring pain during procedures like getting an IV or having a tube inserted. This research focuses on three commonly used scales: FLACC, MBPS, and VASobs. The goal is to figure out which of these scales is the most accurate and helpful for understanding how much pain our children are feeling during these procedures, so they can receive the best care possible.

Behind the Scenes: How the Research Was Done

To understand how well these different pain scales work, researchers conducted a study involving healthcare professionals and video recordings of infants and young children undergoing medical procedures. Here’s a breakdown of what they did:

• The Participants: The study included 26 experienced doctors and nurses, and videos of 100 procedures performed on infants and young children. These procedures included some that are usually painful, such as getting an IV or having a tube inserted into the nose, and others that are typically not painful, like measuring oxygen levels.
• Pain Assessment: The doctors and nurses watched short video clips of the procedures and used the FLACC, MBPS, and VASobs scales to assess the child’s pain level. They also answered questions about how easy each scale was to use and how helpful it was in understanding the child’s pain.
• Data Analysis: The researchers used statistical methods to analyze the results. They looked at how reliable each scale was (did different healthcare professionals give similar pain scores?), how well each scale could tell the difference between painful and non-painful procedures, and how much the pain scores changed depending on the phase of the procedure (before, during, and after).

The researchers also paid close attention to any challenges the healthcare professionals faced while using the scales. This helped them understand how feasible each scale is in a real-life setting.

What the Research Found: Comparing Pain Scales

To understand how well each scale measured pain, the researchers looked at the scores given by the healthcare professionals for each procedure. Here’s what they found:

• VASobs pain scores were consistently lower compared to the other scales. This means that healthcare professionals using this scale might underestimate how much pain a child is actually feeling. As mothers, we want to be sure our children’s pain is taken seriously, so this is concerning.
• MBPS scores were often higher than the other scales, even when children were not undergoing painful procedures. This raises questions about whether the MBPS can reliably distinguish between pain and general distress or anxiety, which are common in hospital settings.
• All three scales showed an increase in scores as the procedures became more painful, suggesting they can respond to changes in pain levels. However, FLACC and MBPS scores also increased during non-painful procedures, indicating they might not be as specific to pain as we would like.
• Healthcare professionals found the VASobs easiest to use, but they were also concerned about its accuracy. They expressed doubts about whether any of the scales truly capture the experience of procedural pain in infants and young children.
• FLACC and MBPS showed good reliability, meaning different healthcare professionals gave similar scores when using these scales. This is important for consistency in pain assessment. However, there were more instances where healthcare professionals couldn’t complete the FLACC scale due to factors like the child being restrained.

Understanding the Findings: Challenges in Measuring Pain in Young Children

The results of this study highlight some of the challenges in accurately measuring pain in infants and young children. While all three scales showed some ability to detect pain, each had its limitations:

• VASobs, despite being easy to use, seems to underestimate pain. This is worrying because it might lead to undertreatment of pain in our little ones.
• MBPS may be too sensitive and pick up on general distress or anxiety rather than just pain. This could lead to confusion about whether a child is truly experiencing pain or just feeling scared or uncomfortable in the hospital environment.
• FLACC seems to be a better option than MBPS for measuring procedural pain, but it has its own limitations. It may not be specific enough to pain, and there are times when it can’t be used due to factors like the child being held or restrained.

The healthcare professionals in the study also shared their concerns about the limitations of these scales. They felt that none of the scales perfectly capture the experience of pain in infants and young children. This emphasizes the need for ongoing research to develop more reliable and accurate ways to measure pain in our little ones.

What This Means for Measuring Pain in Our Children: Looking Forward

This study was carefully designed to compare different pain scales, but it’s important to acknowledge that there were some limitations. For example, the healthcare professionals knew what type of procedure they were watching, which could have influenced their pain assessments. Additionally, while the study used videos to simulate real-life situations, it may not perfectly capture the full experience of being in a hospital and undergoing a procedure.

Despite these limitations, the study provides valuable insights into the challenges of measuring pain in infants and young children. It shows that we need to be cautious when using these scales and consider their limitations.

Looking Ahead: Better Pain Management for Our Little Ones

Based on the findings of this study, researchers recommend using the FLACC scale with caution for assessing pain during procedures. It’s important to remember that the score might reflect not only pain but also general distress or anxiety.

There is a need to continue researching and improving pain assessment tools for infants and young children. This includes revising existing scales like FLACC to make them more accurate and easier to use. By developing better ways to measure pain, we can ensure our children receive the best possible pain management and feel comforted and cared for during their hospital experiences.

Finding the Best Way to Measure Pain: What We Learned

Although there’s no perfect solution yet, this study provides valuable information about measuring pain in infants and young children. While the MBPS was initially designed for this purpose, the research suggests that the FLACC scale might be a better choice for understanding pain during medical procedures. However, it’s important to use FLACC scores cautiously, as they might not solely reflect pain but also include general distress or anxiety that our little ones experience in the hospital setting.

The VASobs scale, although easy to use, appears to underestimate pain levels. This is a concern because it could lead to inadequate pain relief for our children.

Therefore, more research is needed to develop even better ways to measure pain in infants and young children. This includes refining existing scales like FLACC to make them more accurate and user-friendly. By improving our ability to assess pain, we can ensure our children receive the best possible care and comfort when they need it most.