“Ouch!” Blood draws do hurt! Vapocoolants Decrease Venipuncture Pain in Emergency Department Patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/306569
Category:
Abstract
Type:
Poster
Title:
“Ouch!” Blood draws do hurt! Vapocoolants Decrease Venipuncture Pain in Emergency Department Patients
Author(s):
Mace, Sharon E.; Gaul, Elizabeth; Barbour, Tracy M.
Lead Author STTI Affiliation:
Non-member
Author Details:
Sharon E. Mace, MD, FACEP, FAAP, MACES@ccf.org; Elizabeth Gaul, RN; Tracy M. Barbour, CRC
Abstract:

Research Abstract

Purpose: Painful diagnostic or therapeutic procedures are commonly performed in the emergency department (ED). Previous investigations indicate that practitioners frequently do not provide adequate anesthesia for painful medical procedures. Topical anesthetics have been recommended as a method to decrease a patient’s procedural pain. This study determines that a topical vapocoolant spray is effective and safe in adults undergoing venipuncture in the ED.

Design: Prospective blinded randomized controlled efficacy and safety trial of vapocoolant spray on pain in adults (≥ 21 years) undergoing venipuncture in the ED.

Setting: The emergency department at a large, urban, tertiary care hospital.

Participants/Subjects: One hundred adults were evaluated. Demographics were not significantly different for the saline(S) placebo or vapocoolant (V) groups. Results were saline vs. vapocoolant: mean age 51.5 (S) vs. 53.0(V), males 54% (S) vs.38%(V), African-American 58%(S) vs. 66%(V), Caucasian 42%(S) vs. 34%(V).

Methods: Adults were randomized to normal saline placebo spray or vapocoolant spray (Gebauer’s Pain Ease®, 1, 1,1,3,3 pentafluoropropane and 1,1,1,2 tetrafluoroethane) prior to venipuncture. Numeric rating scales (NRS) (1 to 10) were obtained after the spray was given and following venipuncture. Assessment and photographs of the venipuncture site were done pre and post application of both sprays. Vital signs and side effects were documented.

Results/Outcomes: Mean NRS after venipuncture for saline spray was 4.7 cm (SD± 2.9) and for vapocoolant spray was 1.7 cm (SD±2.3) (p< 0.001). Assessment including before and after photographs revealed no pallor, redness, or other abnormalities of the skin at the site of the spray application/ venipuncture. Following application of the spray and prior to the venipuncture, there was no significant difference in mean NRS between the saline or vapocoolant spray with a mean NRS < 1 for either spray, indicating that appropriate application of the vapocoolant spray was not painful or uncomfortable. After the application of the spray and before the venipuncture the NRS was 0.42 (± 1.7) (saline) and vapocoolant 0.88 (± 1.4) (p=0.16, NS). There were no significant differences in vital signs between saline and vapocoolant before and after the spray/venipuncture.

Implications: Vapocoolant is effective and safe for the treatment of the acute pain of venipuncture in ED patients with a significant decrease of 3 in the mean NRS compared with NS (4.7 saline to 1.7 vapocoolant) and was well tolerated with very few minor side effects that resolved quickly. There were no visible abnormalities at the site post application of the spray. Vapocoolant should be offered to every patient prior to venipuncture.

Keywords:
Vapocoolants Decrease Venipuncture Pain
Repository Posting Date:
9-Dec-2013
Date of Publication:
9-Dec-2013
Conference Date:
2013
Conference Name:
2013 ENA Annual Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Nashville, Tennessee, USA
Description:
2013 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at Gaylord Resort and Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.title“Ouch!” Blood draws do hurt! Vapocoolants Decrease Venipuncture Pain in Emergency Department Patientsen_GB
dc.contributor.authorMace, Sharon E.en_GB
dc.contributor.authorGaul, Elizabethen_GB
dc.contributor.authorBarbour, Tracy M.en_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsSharon E. Mace, MD, FACEP, FAAP, MACES@ccf.org; Elizabeth Gaul, RN; Tracy M. Barbour, CRCen_GB
dc.identifier.urihttp://hdl.handle.net/10755/306569-
dc.description.abstract<p>Research Abstract</p><p>Purpose: Painful diagnostic or therapeutic procedures are commonly performed in the emergency department (ED). Previous investigations indicate that practitioners frequently do not provide adequate anesthesia for painful medical procedures. Topical anesthetics have been recommended as a method to decrease a patient’s procedural pain. This study determines that a topical vapocoolant spray is effective and safe in adults undergoing venipuncture in the ED.</p><p>Design: Prospective blinded randomized controlled efficacy and safety trial of vapocoolant spray on pain in adults (≥ 21 years) undergoing venipuncture in the ED.</p><p>Setting: The emergency department at a large, urban, tertiary care hospital.</p><p>Participants/Subjects: One hundred adults were evaluated. Demographics were not significantly different for the saline(S) placebo or vapocoolant (V) groups. Results were saline vs. vapocoolant: mean age 51.5 (S) vs. 53.0(V), males 54% (S) vs.38%(V), African-American 58%(S) vs. 66%(V), Caucasian 42%(S) vs. 34%(V). </p><p>Methods: Adults were randomized to normal saline placebo spray or vapocoolant spray (Gebauer’s Pain Ease®, 1, 1,1,3,3 pentafluoropropane and 1,1,1,2 tetrafluoroethane) prior to venipuncture. Numeric rating scales (NRS) (1 to 10) were obtained after the spray was given and following venipuncture. Assessment and photographs of the venipuncture site were done pre and post application of both sprays. Vital signs and side effects were documented.</p><p>Results/Outcomes: Mean NRS after venipuncture for saline spray was 4.7 cm (SD± 2.9) and for vapocoolant spray was 1.7 cm (SD±2.3) (p< 0.001). Assessment including before and after photographs revealed no pallor, redness, or other abnormalities of the skin at the site of the spray application/ venipuncture. Following application of the spray and prior to the venipuncture, there was no significant difference in mean NRS between the saline or vapocoolant spray with a mean NRS < 1 for either spray, indicating that appropriate application of the vapocoolant spray was not painful or uncomfortable. After the application of the spray and before the venipuncture the NRS was 0.42 (± 1.7) (saline) and vapocoolant 0.88 (± 1.4) (p=0.16, NS). There were no significant differences in vital signs between saline and vapocoolant before and after the spray/venipuncture. </p><p>Implications: Vapocoolant is effective and safe for the treatment of the acute pain of venipuncture in ED patients with a significant decrease of 3 in the mean NRS compared with NS (4.7 saline to 1.7 vapocoolant) and was well tolerated with very few minor side effects that resolved quickly. There were no visible abnormalities at the site post application of the spray. Vapocoolant should be offered to every patient prior to venipuncture.</p>en_GB
dc.subjectVapocoolants Decrease Venipuncture Painen_GB
dc.date.available2013-12-09T16:59:58Z-
dc.date.issued2013-12-09-
dc.date.accessioned2013-12-09T16:59:58Z-
dc.conference.date2013en_GB
dc.conference.name2013 ENA Annual Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationNashville, Tennessee, USAen_GB
dc.description2013 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at Gaylord Resort and Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.en_GB
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