5.00
Hdl Handle:
http://hdl.handle.net/10755/198347
Title:
Topical Anesthetic vs. Distraction for Venipuncture Pain in Emergency Care
Abstract:
[ENA Annual Conference 2011 - Research Presentation]Topical Anesthetic vs. Distraction for Venipuncture Pain in Emergency Care

Purpose: Venipuncture is among the most frequently performed and most painful and anxiety producing procedures that children experience during emergency care. This study evaluated the efficacy of topical analgesia and distraction techniques compared to usual care to decrease pain and increase comfort during venipuncture in children. Kolcaba’s Comfort Theory provided the framework for the study.

Design: A prospective, 3-group posttest-only experimental design was used. Sixty-four child/parent dyads were randomly assigned to groups.

Setting: A tertiary pediatric, free standing, ACS designated Level 2 trauma center emergency department in the mid-Atlantic US region provided the setting for the study.

Participant/Subjects: A convenience sample of children who met these criteria was selected for the study: 3-10 years old; venipuncture anticipated by triage nurse; accompanied by parent or guardian; both child and parent able to understand explanation of study, consent process, and pain and comfort assessment tools in English. Children with obvious major trauma, airway, breathing, or circulatory problems, major disability, immunocompromise, cancer with recent fever, sickle cell disease or trait, or developmental delay lacking cognitive skills needed to use distraction or complete data collection tools were excluded. One parent or guardian of each child also participated in the study. Written consent from a parent or guardian was obtained for all participants; assent was obtained from children 7 and older.

Methods: The triage nurse flagged the charts of children who met inclusion criteria. A study investigator explained the study to parent and child and obtained written consent. Demographic data were collected. Child/parent dyads were placed in their intervention group using a pre-randomized card system. Children in the distraction group chose from among Eye-Spy, View-Master, or blowing bubbles. Children in the anesthetic group had a topical anesthetic cream applied to the proposed venipuncture site at least 30 minutes prior to venipuncture. Those randomized to usual care had the bedside TV on and parent(s) interacting with them. Venipuncture was performed; medical and nursing care proceeded as usual. Children rated their venipuncture pain and comfort 15 minutes after the venipuncture using the Wong-Baker FACES Scale and Kolcaba Comfort Posies Scale. Similarly, parents rated their child’s pain and comfort using a visual analog pain scale and the Kolcaba Comfort Behavior Checklist.

Results/Outcomes: Fifty child/parent dyads provided complete data. Preliminary data analysis indicates that both child and parents in the distraction group provided the highest comfort scores with topical anesthetic providing somewhat less comfort. Children in the distraction group gave the lowest pain ratings. Parents of children in the topical anesthetic group rated their children’s pain lower than parents whose children used distraction. Usual care was least helpful in managing both comfort and pain as rated by both children and parents.

Implications: These data support distraction as an effective alternative to topical anesthetic in managing the pain and discomfort of venipuncture in children. Either is superior to usual care.
Repository Posting Date:
21-Dec-2011
Date of Publication:
21-Dec-2011

Full metadata record

DC FieldValue Language
dc.titleTopical Anesthetic vs. Distraction for Venipuncture Pain in Emergency Careen_GB
dc.identifier.urihttp://hdl.handle.net/10755/198347-
dc.description.abstract[ENA Annual Conference 2011 - Research Presentation]Topical Anesthetic vs. Distraction for Venipuncture Pain in Emergency Care<br/><br/>Purpose: Venipuncture is among the most frequently performed and most painful and anxiety producing procedures that children experience during emergency care. This study evaluated the efficacy of topical analgesia and distraction techniques compared to usual care to decrease pain and increase comfort during venipuncture in children. Kolcaba’s Comfort Theory provided the framework for the study.<br/><br/>Design: A prospective, 3-group posttest-only experimental design was used. Sixty-four child/parent dyads were randomly assigned to groups.<br/><br/>Setting: A tertiary pediatric, free standing, ACS designated Level 2 trauma center emergency department in the mid-Atlantic US region provided the setting for the study. <br/><br/>Participant/Subjects: A convenience sample of children who met these criteria was selected for the study: 3-10 years old; venipuncture anticipated by triage nurse; accompanied by parent or guardian; both child and parent able to understand explanation of study, consent process, and pain and comfort assessment tools in English. Children with obvious major trauma, airway, breathing, or circulatory problems, major disability, immunocompromise, cancer with recent fever, sickle cell disease or trait, or developmental delay lacking cognitive skills needed to use distraction or complete data collection tools were excluded. One parent or guardian of each child also participated in the study. Written consent from a parent or guardian was obtained for all participants; assent was obtained from children 7 and older. <br/><br/>Methods: The triage nurse flagged the charts of children who met inclusion criteria. A study investigator explained the study to parent and child and obtained written consent. Demographic data were collected. Child/parent dyads were placed in their intervention group using a pre-randomized card system. Children in the distraction group chose from among Eye-Spy, View-Master, or blowing bubbles. Children in the anesthetic group had a topical anesthetic cream applied to the proposed venipuncture site at least 30 minutes prior to venipuncture. Those randomized to usual care had the bedside TV on and parent(s) interacting with them. Venipuncture was performed; medical and nursing care proceeded as usual. Children rated their venipuncture pain and comfort 15 minutes after the venipuncture using the Wong-Baker FACES Scale and Kolcaba Comfort Posies Scale. Similarly, parents rated their child’s pain and comfort using a visual analog pain scale and the Kolcaba Comfort Behavior Checklist. <br/><br/>Results/Outcomes: Fifty child/parent dyads provided complete data. Preliminary data analysis indicates that both child and parents in the distraction group provided the highest comfort scores with topical anesthetic providing somewhat less comfort. Children in the distraction group gave the lowest pain ratings. Parents of children in the topical anesthetic group rated their children’s pain lower than parents whose children used distraction. Usual care was least helpful in managing both comfort and pain as rated by both children and parents. <br/><br/>Implications: These data support distraction as an effective alternative to topical anesthetic in managing the pain and discomfort of venipuncture in children. Either is superior to usual care. <br/>en_GB
dc.date.available2011-12-21T12:46:45Z-
dc.date.issued2011-12-21T12:46:45Z-
dc.date.accessioned2011-12-21T12:46:45Z-
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