How Infants and Non-speaking Children are Involved in Decision-making About Their Healthcare Needs in Emergency Departments that Treat Children
When an infant or non-speaking child presents with their parents or carers at the Emergency Department, the triage nurse will assess the infant or child using the following steps:
1. Take a history or account of the problem from the parent/guardian. The nurse will also ask the parent/carer if they think the child is in pain or uncomfortable.
2. Assess the vital signs of the infant or child.
3. Use the r-FLACC Scale [(F) Face, (L) Legs, (A) Activity, (C) Cry, (C) Consolability], a behavioural observational pain scale tool, to analyse the behaviour of the infant or nonspeaking child and determine if she/he is calm, comfortable, responsive and alert. This scale is used for children up to six years of age and children with cognitive impairment.
4. The triage nurse assigns a score for each category of the infant or child’s behaviour and enters these scores into the triage computer system.
5. If the infant or child has a total score of 7-10, she/he is assigned a Category 2 rating, which means the infant or child will be seen by a doctor in under 10 minutes.
6. If the infant or child has a total score of 4-6 and there are no additional concerns, she/ he is assigned a Category 3 rating, which means the infant or child will be seen by a doctor within one hour.
7. If the infant or child has a total score of 0-3 and there are no additional concerns, she/ he is assigned a Category 4 rating, which means the infant or child will be seen by a doctor within two hours.
How the r-FLACC Scale enables infants and children to be given SPACE, VOICE, AUDIENCE and INFLUENCE
Space: 
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Voice:
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Audience:
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Influence:
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