The COMFORT behavioural scale and the modified FLACC scale in paediatric intensive care

Johansson, Monica; Kokinsky, Eva

doi:10.1111/j.1478-5153.2009.00323.x

Cited by 98 publications

(95 citation statements)

References 18 publications

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“…2,22,23,27 In pediatrics, in 1992, Ambuel et al developed a method to evaluate sedation in ventilated patients, the COMFORT scale, which aggregates six behavioral and two physiological parameters. However, the two physiological parameters (blood pressure and heart rate) were excluded to avoid confounding the evaluation and a new scale was validated, the COMFORT Behavior scale, [30][31][32] which is the scale recommended (level A evidence) for management and evaluation of sedation in pediatrics, used every 4 to 8 hours, as required based on the patient conditions. 4,33 The COM-FORT-B scale is also validated in Portuguese, with its use recommended.…”

Section: Resultsmentioning

confidence: 99%

Importance of the use of protocols for the management of analgesia and sedation in pediatric intensive care unit

Motta

Luglio²,

Delgado

et al. 2016

Rev. Assoc. Med. Bras.

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Summary Introduction: Analgesia and sedation are essential elements in patient care in the intensive care unit (ICU), in order to promote the control of pain, anxiety and agitation, prevent the loss of devices, accidental extubation, and improve the synchrony of the patient with mechanical ventilation. However, excess of these medications leads to rise in morbidity and mortality. The ideal management will depend on the adoption of clinical and pharmacological measures, guided by scales and protocols. Objective: Literature review on the main aspects of analgesia and sedation, abstinence syndrome, and delirium in the pediatric intensive care unit, in order to show the importance of the use of protocols on the management of critically ill patients. Method: Articles published in the past 16 years on PubMed, Lilacs, and the Cochrane Library, with the terms analgesia, sedation, abstinence syndrome, mild sedation, daily interruption, and intensive care unit. Results: Seventy-six articles considered relevant were selected to describe the importance of using a protocol of sedation and analgesia. They recommended mild sedation and the use of assessment scales, daily interruptions, and spontaneous breathing test. These measures shorten the time of mechanical ventilation, as well as length of hospital stay, and help to control abstinence and delirium, without increasing the risk of morbidity and morbidity. Conclusion: Despite the lack of controlled and randomized clinical trials in the pediatric setting, the use of protocols, optimizing mild sedation, leads to decreased morbidity.

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Section: Resultsmentioning

confidence: 99%

Importance of the use of protocols for the management of analgesia and sedation in pediatric intensive care unit

Motta

Luglio²,

Delgado

et al. 2016

Rev. Assoc. Med. Bras.

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show abstract

“…The interobserver reliability of the total CBS was 0⋅71 [95% confidence interval (CI) = 0⋅65-0⋅77], and the weighted kappa ranged from 0⋅43 (muscle tone) to 0⋅78 (respiratory response) (Johansson and Kokinsky, 2009). One study found a K index indicating moderate agreement between doctors and nurses.…”

Section: Comfort Behaviour Scalementioning

confidence: 99%

Psychometric analysis of subjective sedation scales used for critically ill paediatric patients

Zhang

Zhou

2017

Nursing in Critical Care

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Aims: This study evaluated the psychometric properties of subjective sedation scales using one psychometric scoring system to identify the appropriate scale that is most suitable for clinical care practice. Background: A number of published sedation assessment scales for paediatric patients are currently used to attempt to achieve a moderate depth of sedation to avoid the undesirable effects caused by over-or undersedation. However, there has been no systematic review of these scales. Search strategy: We searched the Cochrane Library, PubMed, EMBASE, the Cumulative Index to Nursing and Allied Health Literature, etc., to obtain relevant articles. The quality of the selected studies was evaluated according to the Consensus-based Standards for the Selection of Health Measurement Instruments checklist. Inclusion criteria: Articles that had been published or were in press and discussed the psychometric properties of sedation scales were included. The population comprised critically ill infants and non-verbal children ranging in age from 0 to 18 years who underwent sedation in an intensive care unit. Findings: Data were independently extracted by two investigators using a standard data extraction checklist: 43 articles were included in this review, and 13 sedation scales were examined. The quality of the psychometric evidence for the Comfort Scale and Comfort Behaviour Scale was 'very good', with the Comfort Scale having a higher quality (total weighted scores, Comfort Scale = 17⋅3 and Comfort Behaviour Scale = 15⋅5). Conclusions: We suggest that the scales be systematically and comprehensively tested in terms of development method, reliability, validation, feasibility and correlation with clinical outcome. The Comfort Scale and Comfort Behaviour Scale are useful tools for measuring sedation in paediatric patients. Relevance to clinical practice: Nursing staff should choose one subjective sedation scale that is suitable for assessing paediatric patients' depth of sedation. We recommend the Comfort Scale and Comfort Behaviour Scale as optimal choices if the clinical environment permits.

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“…FLACC scale was translated into four languages (Chinese, Thai, Swedish, and Brazilian Portuguese) [9][10][11][12]. SEM (Sound-Eye-Motor) scale has been used in many recent studies [13][14][15][16][17] and Baghdadi study in Syria [18], this scale concentrates on the changes in patient's sound, eyes and movement to evaluate patients relax or pain during treatment [19].…”

Section: Literature Reviewmentioning

confidence: 99%

The Validity and Reliability of the Arabic Version of FLACC Scale: A Clinical Trial

Albab¹,

Shakhashero²

2016

J Anesth Clin Res

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The COMFORT behavioural scale and the modified FLACC scale in paediatric intensive care

Abstract: The use of validated scales may improve the assessment and management of pain and sedation in intubated children.

Cited by 98 publications

References 18 publications

Importance of the use of protocols for the management of analgesia and sedation in pediatric intensive care unit

Importance of the use of protocols for the management of analgesia and sedation in pediatric intensive care unit

Psychometric analysis of subjective sedation scales used for critically ill paediatric patients

The Validity and Reliability of the Arabic Version of FLACC Scale: A Clinical Trial

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