Article Text

  1. E Fournier-Charriere1,
  2. C H Ricard2,
  3. F Lassauge3,
  4. B Tourniaire4,
  5. P Cimerman5,
  6. P Turquin6,
  7. B Falissard7,
  8. A Letierce8,
  9. F Reiter1,
  10. B Lombart4,
  11. R Carbajal5
  1. 1Service Douleur, Hopital Bicetre, AP-HP, Le Kremlin Bicetre, France
  2. 2Service Douleur, Hopital Lapeyronie, Montpellier, France
  3. 3Service Douleur, Hopital Saint Jacques, Besancon, France
  4. 4Service Douleur, Hopital Trousseau, AP-HP, Paris, France
  5. 5CNRD, Hopital Trousseau, AP-HP, Paris, France
  6. 6Urgences Enfant, Hopital Bicetre, AP-HP, Le Kremlin Bicetre, France
  7. 7INSERM U669, Hopital Cochin, AP-HP, Paris, France
  8. 8Service de Recherche Clinique, Hopital Bicetre, AP-HP, Le Kremlin Bicetre, France


In the emergency department, pain has to be assessed quickly, in order to choose the appropriate analgesic. A simple behavioural scale was needed for young children under 6 years.

Elaboration EVENDOL was elaborated by paediatric pain specialists and emergency staff members. The scale includes five items: complaint, grimace, movements, postures, interaction with surroundings, each scored from 0 to 3.

Validation The scale was tested at three times: before any care, during mobilisation, after analgesic. Construct validity and interrater reliability were studied. Children were assessed by the nurse and the searcher, with EVENDOL and with a visual analogue scale (VAS) and with other scales. Anxiety and asthenia levels were assessed. Self-assessment scores were obtained from children above 4 years of age.

Results 297 children (1 month to 6 years) were included.

Construct Validity Scores before/after nalbuphine varied from 8.14 to 3.62 at rest (p<0.0001), from 11.87 to 6.65 at mobilisation (p = 0.0011); correlations between VAS and EVENDOL: 0.79 to 0.92 at all times (p<0.0001); correlations between EVENDOL and other behavioural pain scales (EDIN, CHEOPS, FLACC, TPPPS): 0.5 to 0.93 (concurrent validity); correlations between FPS-R and EVENDOL in 4–6-year-old children varied between 0.64 and 0.93; correlations between EVENDOL and tiredness and anxiety were bad (0.15 to 0.34) (discriminant validity).

Content Validity Excellent Cronbach coefficient (0.83 to 0.92). Interrater reliability between nurses and researcher: correlations 0.89 to 0.98, weighted kappa 0.7 to 0.9.

Conclusion EVENDOL, a new five-item scale to assess young children’s pain in the emergency department is validated. EVENDOL is simple and well accepted by nurses.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.