Y Liza Kearl1, Sheryl Yanger2, Sandra Montero3, Elizabeth Morelos-Howard3, Ilene Claudius4. 1. USC, Keck School of Medicine, Department of Emergency Medicine and Pediatrics, Los Angeles, CA. 2. LAC+USC, Department of Pediatrics, Los Angeles, CA; University of Texas at Austin, Austin, TX. 3. LAC+USC, Department of Emergency Medicine, Los Angeles, CA. 4. USC, Keck School of Medicine, Department of Emergency Medicine and Pediatrics, Los Angeles, CA. Electronic address: iaclaudius@gmail.com.
Abstract
BACKGROUND: Both the J-tip® (a needle-free device for subcutaneous delivery of lidocaine) and the Buzzy® (a cooled, vibrating device to employ gate control to minimize procedural pain) have shown some efficacy in diminishing the pain of venipuncture. PURPOSE: To develop an optimal protocol for pre-venipuncture/IV start pain management by investigating the impact of adding the use of Buzzy® prior to the use of the J-tip®. PROCEDURES: Pediatric emergency department patients aged 1 month to 21 years were prospectively enrolled in Phase 1 (J-tip® only) then Phase 2 (Buzzy®+J-tip®) for analgesia prior to venipuncture or IV start. Age-appropriate pain scale scores were collected for the subsequent procedure, as well the administration of lidocaine via J-tip®. MAIN FINDINGS: With the combined intervention (phase 2), 14.2% of patients had a pain scale score >3 with venipuncture and 16.1% had a pain scale score >3 with application of the J-tip® itself. With no intervention for pain relief, 71% of patients experienced a pain scale score >3 for venipuncture. With the J-tip® alone (phase 1), 21% had a pain scale score >3 with venipuncture and 22.3% had a pain scale score >3 with application of the J-tip® itself. CONCLUSIONS: Patients receiving either intervention reported lower scores on pain scales during venipuncture or IV start than the no analgesia group. The combined intervention did not yield a significant decrease in scores on pain scale scores over the J-tip® alone.
BACKGROUND: Both the J-tip® (a needle-free device for subcutaneous delivery of lidocaine) and the Buzzy® (a cooled, vibrating device to employ gate control to minimize procedural pain) have shown some efficacy in diminishing the pain of venipuncture. PURPOSE: To develop an optimal protocol for pre-venipuncture/IV start pain management by investigating the impact of adding the use of Buzzy® prior to the use of the J-tip®. PROCEDURES: Pediatric emergency department patients aged 1 month to 21 years were prospectively enrolled in Phase 1 (J-tip® only) then Phase 2 (Buzzy®+J-tip®) for analgesia prior to venipuncture or IV start. Age-appropriate pain scale scores were collected for the subsequent procedure, as well the administration of lidocaine via J-tip®. MAIN FINDINGS: With the combined intervention (phase 2), 14.2% of patients had a pain scale score >3 with venipuncture and 16.1% had a pain scale score >3 with application of the J-tip® itself. With no intervention for pain relief, 71% of patients experienced a pain scale score >3 for venipuncture. With the J-tip® alone (phase 1), 21% had a pain scale score >3 with venipuncture and 22.3% had a pain scale score >3 with application of the J-tip® itself. CONCLUSIONS:Patients receiving either intervention reported lower scores on pain scales during venipuncture or IV start than the no analgesia group. The combined intervention did not yield a significant decrease in scores on pain scale scores over the J-tip® alone.
Authors: Nivedita Jain; Preene Juneja; Updesh Masih; A K Bharath Bhushan; Upendra Singh Bhaduaria; Khushboo Badjatya Journal: J Family Med Prim Care Date: 2021-11-29