In response to the Ask the Experts column in the October issue (October 2004:68–73) on pain and sedation assessment in nonresponsive patients in the intensive care unit, I would like to make readers aware of another tool that can be used for pain assessment. This tool is currently being implemented in at least 14 health-care systems in the United States and Canada. Accurate pain assessment has been a major focus in our burn-trauma intensive care unit over the last several years. In response to this concern, we initially began using the FLACC, a child-based scale, that was recommended to us by an accrediting agency as the best available tool for pain assessment of nonverbal patients. The nursing staff was very dissatisfied with this tool and felt that it was not appropriate for sedated, nonresponsive adult patients receiving mechanical ventilation....

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