A 14-year-old with spastic quadriplegic cerebral palsy and significant cognitive impairments is post-op day 1 from a pelvic osteotomy. Upon initial exam, you need to record a pain score. Which is the most appropriate pain scale to use with this individual?

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For a child who is nonverbal or not of an age to participate in a self-reporting scale, a behavioral pain scale is needed. Two such scales are the Face, Legs, Activity, Cry, and Consolability (FLACC) behavioral pain scale and the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) (McGrath et al, 1985), both for children up to 7 years of age. For children who are cognitively intact and able to participate in reporting their pain, there are also several scales to choose from. The Wong-Baker Faces scale (Wong & Baker, 1988) asks children, aged 3 to 7 years, to pick from five different faces according to their pain level. The CRIES (cry, requires O₂, increased vital signs, expression, sleeplessness) is used with neonates.

A 14-Year-Old with Spastic Quadriplegic Cerebral Palsy and Significant Cognitive