Venipuncture In Children Research Articles

Effectiveness of non-pharmacological methods on pain intensity due to venipuncture in children: A systematic review and meta-analysis

Background and aims: Therapeutic procedures, including the placement of intravenous catheters, are among the most common sources of pain for children. Various methods exist to reduce pain during venipuncture in children, including non-pharmacological methods, but there is no consensus on the most effective approach. The aim of this study is to evaluate the effectiveness of non-pharmacological methods on pain intensity during venipuncture in children. Methods: This systematic review and meta-analysis were conducted based on English and Persian articles published in the databases of PubMed, Web of Science, Scopus, CINAHL, ScienceDirect, Google Scholar, Irandoc, Iranmedex, SID, and Magiran between 1911 and 2023, using the keywords Venipuncture, Children, Pain, and their MeSH equivalents in all possible combinations. Data analysis was performed using STATA 11 software. Results: Out of 6963 studies obtained from the initial search, 17 eligible articles were included in the meta-analysis. The results of the random effects model showed that among non-pharmacological methods, the pain score of children in the distraction intervention group was 1.72 points lower than that of children in the comparison group, placing it in the strong effectiveness category. Furthermore, distraction interventions were found to be more effective in children under 8.5 years old, with bubble-blowing interventions proving to be the most effective among all. The findings in other groups also showed that acupressure and educational booklet reading interventions performed by the child on a teddy bear were more effective than distraction interventions. Conclusion: Non-pharmacological interventions seem to be an easy, accessible, and cost-effective method for nurses to manage pain associated with venipuncture according to children’s age.

Comparative efficacy of pharmacological and non-pharmacological interventions for mitigating pain and anxiety associated with venipuncture: a randomised controlled trial

BackgroundVenipuncture is one of the most commonly performed medical procedures in paediatric care, but it can also be one of the most painful and distressing experiences for patients. Finding effective...

The Effect of Watching Cartoon on Pain and Anxiety of Venipuncture in 3-6 Year-Old Children: A Randomized Controlled Clinical Trial

Background: Injection-induced anxiety in children is a significant issue, as the pain from injections creates both physical and psychological stress, reducing the child's tolerance and cooperation. Objectives: To determine the effect of watching a cartoon on venipuncture-induced pain and anxiety among 3 - 6-year-old hospitalized children. Methods: In this randomized controlled clinical trial, children admitted to the pediatric ward of Bu-Alisina Hospital in Sari were randomly allocated to intervention and control groups. For the intervention group, the distraction technique of watching a cartoon was used during venipuncture. The demographic and medical information was collected using a questionnaire, and pain and anxiety were assessed using the Spence Children’s Anxiety Scale (SCAS)-Parents version, the face, legs, activity, cry, and consolability (FLACC) Behavioral Pain Scale, and the Facial Image Scale (FIS) before and during venipuncture. Data analysis was performed using non-parametric tests, with a significance level set at less than 0.05. Results: A total of 140 children were studied in two groups, with 78 (55.71%) being boys. The mean age of children in the intervention group was 52.44 ± 14.37 months, and in the control group, it was 50.91 ± 15.66 months. In the intervention group, the mean pain ranks before and after venipuncture were 4.17 ± 2.36 and 6.0 ± 2.42, respectively, while in the control group, they were 4.40 ± 1.96 and 6.93 ± 2.21, respectively. The mean anxiety ranks before and after venipuncture were 2.61 ± 1.32 and 3.26 ± 1.35 in the intervention group, and 2.80 ± 1.016 and 3.80 ± 0.99 in the control group. The mean pain and anxiety ranks after venipuncture were significantly different between the groups (P < 0.05). Additionally, the mean ranks of pain and anxiety before and after venipuncture were significantly different within both groups (P < 0.001). Conclusions: Based on the results of this study, the cartoon distraction technique effectively reduced pain and anxiety caused by venipuncture in children.

Developing a community-based model of care for venipuncture in children and young adults with an intellectual disability: a retrospective study

BackgroundRegular blood tests for monitoring metabolic side effects are often unable to be collected for people with an intellectual/developmental disability (ID/DD) and challenging behaviours (CBs) using usual pathways. We aimed...

Effects of improved right subclavian vein catheterization on the direction of the catheter tip in children

Background. Catheter tip malposition is commonly observed during subclavian vein catheterization. This study was to investigate whether position and partially retracted the guide wire could reduce catheter malposition. Methods. The children needing right subclavian venipuncture catheterization were randomly divided into two groups: test group A (82 patients) and control group B (82 patients). In group A, catheterization was performed with the patient in a supine position and the guide wire partially retracted during placement. In contrast, in group B, catheterization was done with the patient in Trendelenburg without partial retraction of the guide wire. The catheter tip direction was examined using intraoperative ultrasound, and a postoperative chest X-ray was obtained. Results. The rate of correct catheter tip direction at first insertion was higher in group A compared to group B (86.2% vs. 66.7%, P < 0.05). There were no significant differences in incidence and general data between the two groups. The repeated vascular puncture was unsuccessful in three patients (2 cases in group A and 1 case in group B), and right internal jugular vein catheter instead. Conclusions. The guide wire can be partially retracted in the supine position to reduce catheter tip malposition during right subclavian venipuncture in children.

Effectiveness of Using Video Clip on Reduction of Anxiety During Venipuncture among Children in a Selected Hospital of Eastern Nepal

Introduction: Venipuncture can produce extreme anxiety to children who undergo it. Video clip as distraction is a simple technique which does not require any specific training and can be implemented by nurses, parents or other health staff members in any settings. Besides, it has a minimal cost and implies no risks for the children. This study aimed to assess the anxiety of children during venipuncture and determine the effectiveness of video clip in reducing anxiety. Methods: A posttest only experimental research was conducted in BP Koirala Institute of Health Sciences (BPKIHS), Dharan Nepal including 50 school age children undergone venipuncture. Random sampling technique was applied to recruit respondents. Respondents were randomly assigned either to the experimental or control group with 25 in each. The Experimental group were shown video clip 3 minutes prior to the venipuncture till 3 minutes after completion of venipuncture while Control group had gone a routine venipuncture procedure only during venipuncture. Pearson’s chi square test and Fisher’s exact test was used for the analysis of anxiety response of both group. Results: Showing video clips was effective in reducing venipuncture in children (p=0.001). Among the participants, 72% had high anxiety in control group while it was 24% in experimental group. In a same way 76% had low anxiety in the experiment group while it was 28% among control group. There is a significant difference in the anxiety level between the study and control group (p=0.001). Conclusion: This study suggests that video clip is safe and cost effective method in reduction of anxiety in children undergoing venipuncture.

Efficacy and safety of the Valsalva maneuver in relieving venipuncture pain in children and adults: A systematic review and meta-analysis.

Venipuncture is a common invasive clinical procedure, and pain management during puncture has been of interest to healthcare professionals. The purpose of this systematic review and meta-analysis was to evaluate the efficacy and safety of the Valsalva maneuver (VM) for the relief of venipuncture pain in children and adults. PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, VIP database, and CBM were searched from inception to December 2023 for all available randomized controlled trials (RCTs) that evaluated the impact of VM on venipuncture. Two reviewers independently performed study selection, data extraction, and risk of bias assessment. Continuous variables were analyzed by mean differences (MD) or standardized mean differences (SMD), whereas dichotomous variables were analyzed by risk ratios (RR). A total of 22 studies involving 1740 participants were included. The pooled results showed that VM relieved pain intensity during venipuncture in children (SMD = -0.89, 95% CI = -1.47 to -0.30, p = 0.003) and adults (SMD = -1.11, 95% CI = -1.46 to -0.77, p < 0.00001), reduced anxiety intensity (SMD = -1.07, 95% CI = -1.68 to -0.47, p = 0.0005), and shortened puncture time (MD = -13.52, 95% CI = -21.14 to -5.90, p = 0.0005). There was no significant difference in the success rate of venous cannulation, MAP, HR, or incidence of adverse events in subjects who performed VM compared to controls. VM was an effective and safe method of pain management that reduced pain intensity during venipuncture in children and adults without significant adverse effects. The results of this meta-analysis need to be further validated by more rigorous and larger RCTs.

Interventions to alleviate anxiety and pain during venipuncture in children with chronic gastrointestinal and/or liver disease: A single-center prospective observational study.

The goal of this longitudinal study was to reduce anxiety and pain in children with chronic conditions from the gastrointestinal tract during venipuncture. These children undergo regular venipuncture as part of their medical management and the procedure is often accompanied with anxiety and pain. In addition, children as well as their parents and health care professionals (HCPs) often suffer "compassionate pain" because of emotional interference. In a realistic clinical setting, different psychological and medical interventions were examined: (1) Psychoeducational brochures and (2) four different medical-technical interventions during venipuncture. In a large hospital in Germany, 169 children, their parents, and HCPs were asked to rate anxiety and pain during venipuncture before and after the intervention. Children showed a clear preference for some of the medical-technical interventions. Using Linear Mixed Models anxiety and pain rated by the children themselves showed no significant reduction. However, parents and HCPs reported a significant reduction. Age, gender, and status of liver transplantation were associated with a reduction in anxiety and pain in most of the analyses. Both psychoeducational brochures and medical-technical interventions had a positive impact on anxiety and pain. However, effectivity for the medical-technical interventions was lower than in previous studies utilizing individual interventions. Reasons for this difference as well as possibilities to improve the intervention are discussed. In addition, this study provides practical day-to-day information about the implementation of interventions for the work in pediatric units such as when and how to provide psychoeducational materials.

Comparison of the Effectiveness of EMLA Cream, 2% Lidocaine Gel, and Ice Bag on Pain Intensity Caused by Venipuncture in Children Aged 6-12 Years

Background and Objectives Intravenous catheter placement is one of the most common invasive care measures performed by nurses. Considering the contradictory results obtained regarding the effect of local analgesic techniques, the present study was conducted to compare the effect of EMLA cream vs. 2% lidocaine gel vs. ice bag on pain intensity caused by venipuncture in children aged 6-12 years. Subjects and Methods In this clinical trial, 160 children undergoing elective surgery were selected according to the inclusion and exclusion criteria and were divided into 4 groups of 40 using block randomization method. In this study, pain intensity was measured based on patient self-report and by nurses during venipuncture while applying EMLA cream, 2% lidocaine gel, and ice bag using the numeric analog scale (NAS) and the FLACC scale which included 5 criteria for child behavior. The range of scores in both scales is recorded from 0 to 10, where 0 indicates absence of pain. The data were collected using dispersion indices. Kruskal-Wallis test and chi-square test were used to compare the numerical scale of pain and behavior between groups using SPSS-16 statistical software. Results The mean age of the participants was 7.79±1.79 years, and 80 (50%) were male. The results showed that the mean values of pain intensity based on the numerical scale in the control, EMLA cream, lidocaine gel, and ice bag group were 4±0.78, 0.9±0.75, 2.80±0.18, and 2.60±0.67, respectively. Moreover, there was a statistically significant difference between the groups according to numerical scale and behavioral scale (P&lt;0.001), with the EMLA cream group expressing a lower level of pain based on both scales. Conclusion The results of the present study showed that the use of all three methods of EMLA cream, lidocaine gel, and ice bag reduced pain during venipuncture. The EMLA cream was associated with a higher amount of pain reduction compared to the other two methods. Therefore, EMLA cream could be recommended to be used routinely in the target area one hour before catheter placement.

Family participatory clown therapy in venipuncture in hospitalized children: A non-randomized controlled trial.

To explore the effectiveness of family participatory clown therapy in venipuncture in hospitalized children. We recruited 104 children aged 3 to 6 years for a non-randomized controlled trial from March to December 2022. All participants required peripheral venepuncture infusions for treatment. The children were assigned to either the control group (n = 52) or the experimental group (n = 52).Standard care was utilized in the control group. In the experimental group, two clown nurses and a parent provided family participatory clown therapy for 35-45 minutes per child before, during, and after venipuncture. We assessed children's pain (FLACC and W-B FPS), anxiety (VAS-A), medical fear (CFS), crying incidence, compliance, parental anxiety (S-AI), and parental satisfaction. At venipuncture, the FLACC score was lower in the experimental group (4.46±2.053) compared to the control group (5.96±2.441), the W-B FPS score was also lower in the experimental group (4.96±2.392) than in the control group (6.35±2.266), with a statistically significant difference (P<0.05).The children in the experimental group had lower levels of anxiety, medical fear, crying, and parental anxiety than the control group. In addition, child compliance and parent satisfaction were higher in the experimental group than in the control group, with statistically significant differences (P<0.05). Family participatory clown therapy can reduce pain, anxiety, medical fear, and crying during venipuncture in children. It can also improve venipuncture compliance, reduce parental anxiety, and increase parental satisfaction.

Therapeutic communication improves patient comfort during venipuncture in children: a single-blinded intervention study

The aim of this study was to examine whether therapeutic communication improves children’s comfort during venipuncture compared to standard communication. This study was registered in the Dutch trial register (NL8221), December 10, 2019. This single-blinded interventional study was carried out in an outpatient clinic of a tertiary hospital. Inclusion criteria were age between 5 and 18 years, use of topical anesthesia (EMLA) and sufficient understanding of the Dutch language. 105 children were included, 51 assigned to the standard communication group (SC group) and 54 patients to the therapeutic communication group (TC group). The primary outcome measure was self-reported pain based on the Faces Pain Scale Revised (FPS-R). Secondary outcome measures were observed pain (numeric rating scale (NRS)), self-reported/observed anxiety in child and parent (NRS), self-reported satisfaction in child, parent and medical personnel (NRS), and procedural time. No difference was found for self-reported pain. Self-reported and observed anxiety (by parents and medical personnel) was lower in the TC group (p-values ranged from p = 0.005 to p = 0.048). Procedural time was lower in the TC group (p = 0.011). Satisfaction level of medical personnel was higher in the TC group (p = 0.014). Conclusion: TC during venipuncture did not result in lower self-reported pain. However, secondary outcomes (observed pain, anxiety and procedural time) were significantly improved in the TC group.What is Known:• Medical procedures, especially needle related procedures, cause anxiety and fear in children and adults.• In adults communication techniques based on hypnosis are effective in reducing pain and anxiety during medical procedures.What is New:• Our study found that with a small change in communication technique (called therapeutic communication or TC), the comfort of children during venipuncture improves.• This improved comfort was mainly reflected by reduced anxiety scores and shorter procedural time. This makes TC suitable for the outpatient setting.

Effects of Virtual Reality Education on Procedural Pain and Anxiety During Venipuncture in Children: A Randomized Clinical Trial.

BackgroundVenipuncture is one of the most frequent and frightening medical procedures for children. This randomized clinical trial aimed to evaluate whether pre-procedural immersive virtual reality (VR) education could decrease pain and anxiety during venipuncture procedure of children.MethodsSixty children scheduled for venipuncture at the phlebotomy unit were randomized into either the control or VR group. Before the procedure, children of the control group received conventional simple verbal instructions, whereas those of the VR group experienced a 4-min VR education regarding venipuncture. The primary outcome was the pain and anxiety of pediatric patients assessed with the children’s hospital of eastern ontario pain scale. Secondary outcomes were parental satisfaction, venipuncture time, repeated procedure and procedural difficulty rated by phlebotomists.ResultsThe pain and anxiety score during the procedure was significantly lower in the VR group than in the control group (median [IQR], 6.0 [5.0–7.0] vs. 8.0 [6.0–9.8], P = 0.001). Parental satisfaction about the procedural process were higher in the VR group than in the control group (P = 0.029), and the degree of procedural difficulty was lower in the VR group, compared to the control group (P = 0.026).ConclusionThe preprocedural VR education significantly reduced pain and anxiety of children and decreased the procedural difficulty of phlebotomists during venipuncture procedure.Clinical Trial RegistrationUniversity hospital Medical Information Network Clinical Trials Registry (registration number: UMIN000042968, date of registration: January 9, 2021, URL: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000049043).

CUIDADOS DE ENFERMAGEM NA CATETERIZAÇÃO INTRAVENOSA PERIFÉRICA EM CRIANÇAS HOSPITALIZADAS: REVISÃO INTEGRATIVA

ABSTRACT Objective: to describe nursing care in peripheral intravenous catheterization in hospitalized children. Method: integrative review carried out in November 2020 in LILACS, CINAHL, MEDLINE, SciELO, BDENF and COCHRANE databases. The analysis was constructed from the processes of this review. Results: 19 articles were analyzed, classified according to the level of evidence: level II (5%), level IV (21%), level V (5%), level VI (63%) and level VII (5%). Analytical category "Care for hospitalized child requiring peripheral intravenous catheter". Ultrasound was considered a useful technology. The most used and recommended catheter is the 24 Gauge caliber and the ideal dressing is to use sterile transparent film. Venipuncture in children is more difficult than adults and is often associated with adverse events. Elective catheter replacement is not recommended in children, but there are still doubts. The Difficult Intravenous Access score determines the probability of catheterization failure. Specialized and trained nursing professionals make a difference in this procedure. One should be concerned with pain, using pharmacological and non-pharmacological devices to minimize it. Conclusion: this review contributes to good practices in the care of peripheral intravenous catheterization in children and was based on data on the main technologies used, forms of prevention of adverse events, as well as nursing actions that ensure the safest and least stressful process for children and their families.

A Sorrow Shared Is a Sorrow Halved? Patient and Parental Anxiety Associated with Venipuncture in Children before and after Liver Transplantation

Taking blood via venipuncture is part of the necessary surveillance before and after liver transplantation. The spectrum of response from children and their parents is variable, ranging from a short and limited aversion to paralyzing phobia. The aim of this retrospective, cross-sectional study was to determine the level of anxiety amongst children during venipuncture, to compare the anxiety reported by children and parents, and to identify the factors affecting the children’s and parents’ anxiety in order to develop therapeutic strategies. In total, 147 children (aged 0–17 years, 78 female) and their parents completed questionnaires. Statistical analysis was performed using qualitative and quantitative methods. Results showed that the majority of children reported anxiety and pain during venipuncture. Younger children had more anxiety (self-reported or assessed by parents). Children and parental reports of anxiety were highly correlated. However, the child’s anxiety was often reported as higher by parents than by the children themselves. The child’s general anxiety as well as the parents’ perceived stress from surgical interventions (but not the number of surgical interventions) prompted parental report of child anxiety. For children, the main stressors that correlated with anxiety and pain were factors during the blood collection itself (e.g., feeling the puncture, seeing the syringe). Parental anxiety was mainly related to circumstances before the blood collection (e.g., approaching the clinic, sitting in the waiting room). The main stressors mentioned by parents were the child’s discomfort and their inability to calm the child. Results indicate that the children’s fear of factors during the blood collection, along with the parents’ perceived stress and helplessness as well as their anticipatory anxiety are important starting points for facilitating the drawing of blood from children before and after liver transplantation, thereby supporting a better disease course in the future.

A randomized controlled trial of ultrasound-assisted technique versus conventional puncture method for saphenous venous cannulations in children with congenital heart disease

BackgroundThe study investigated the success rate of the great saphenous venous catheter placement performed by ultrasound-assisted technique compared with the conventional puncture method in infants and toddlers with congenital heart disease and aimed to assess the efficiency and feasibility of this method within the context of pediatric peripheral venous access.MethodsWe selected infants and toddlers who underwent congenital cardiac surgery in our medical center from June 1, 2020, to September 7, 2020, by convenience sampling. Children were stratified by the presence of the manifesting cardiac types (cyanotic or acyanotic heart disease). They were assigned to the conventional puncture method group or the ultrasound-assisted group through randomly blocked randomization. The primary outcome was the success rate of the first attempt. The second outcomes included the time to cannulation at the first attempt, the redirections of the first attempt, overall puncture time, and overall redirections of efforts. Besides, a binary logistic regression model was implemented to identify the possible variables related to the success rate of the first attempt.ResultsA total of 144 children in our medical center were recruited in the study. The success rate of the first attempt in the ultrasound-assisted group was higher than that of the conventional puncture method group in the stratification of cyanotic children (66.7% vs. 33.3%, P = 0.035). Among children of acyanotic kind, the difference in the success rate of the first attempt between the two groups was not significant (57.6% vs. 42.4%, P = 0.194). Overall puncture time (45.5 s vs. 94 s, P = 0.00) and the time to cannulation at the first attempt (41.0 s vs. 60 s, P = 0.00) in the ultrasound-assisted group was less than the conventional puncture method group. The ultrasound-assisted group also required fewer redirections of the first attempt (three attempts vs. seven attempts, P = 0.002) and fewer total redirections of efforts (two attempts vs. three attempts, P = 0.027) than the conventional puncture method group. The result of binary Logistic regression showed that the success rate of the first attempt was related to age (OR:1.141; 95% CI = 1.010–1.290, P = 0.034), the redirections of the first attempt (OR:0.698; 95% CI = 0.528–0.923, P = 0.012) and the saphenous venous width (OR:1.181; 95% CI = 1.023–1.364, P = 0.023).ConclusionsThe ultrasound-assisted technique improves the saphenous venous cannulation sufficiently in children with difficult peripheral veins. The younger age is associated with a higher likelihood of peripheral venous difficulty. The ultrasound-assisted methods can effectively screen peripheral veins, e.g., selecting thicker diameter peripheral veins, making puncture less uncomfortable, and improving success rates. This method can be used as one of the effective and practical ways of peripheral venipuncture in children, especially in difficult situations. It should be widely applied as one of the alternative ultrasound techniques in the operating room.Trial registrationChiCTR.org.cn (ChiCTR-2,000,033,368). Prospectively registered May 29, 2020.

A comparison of the impact of time on the analgesic efficacy of emla cream application in children undergoing venipuncture: A randomized controlled trial

BackgroundIntravenous catheterization (venipuncture) is a common and relatively painful procedure carried out routinely in healthcare facilities. Topical Eutectic Mixture of Local Anesthetics (EMLA) has been advocated to reduce the pain associated with venipuncture in children. However, it is not precisely understood how long EMLA should be applied prior to the procedure. Some studies recommend the use of EMLA at least 60 min prior to the procedure. This study was performed to evaluate the effectiveness of EMLA when used with a shorter preparation time prior to the procedure. MethodsIn this double-blinded clinical trial, 231 patients aged 2 to 6 years were enrolled and randomly allocated into three groups. Group 1 received EMLA cream 20 min before venipuncture, group 2 received EMLA cream 60 min before venipuncture, and group C received vitamin A ointment as a control group. Pain intensity was recorded in groups based on the FLACC score. Study participants, nurses, and evaluators were blinded to the treatment group. ResultsPain severity was lower in groups 1 (mean score = 1.96) and 2 (mean score = 1.56) compared to the controls (mean score = 8.7; P<0.001). There was no difference in pain severity between groups 1 and 2 (P = 0.134). ConclusionEMLA cream significantly reduces the pain associated with venipuncture in children. Also, the application of topical EMLA 20 min before venipuncture is as practical as using it 60 min before this procedure.

Penggunaan Vein Viewer Oleh Perawat Dalam Melakukan Tindakan Venipuncture Pada Pasien Anak

As the development of technology either vein viewer continues to develop. The use of vein viewers in hospitals helps medical personnel especially nurses to perform venipuncture. Aim of this literature review is to identify the use of vein viewers by nurses to performing venipuncture in children. This literature review uses the Sciendirect, ProQuess, Google Scholar, and IEEE Xplore databases to find journal articles that are relevant to the 2015- 2019 limits using several keywords. Result of analyzed and obtained 5 journal which related with topic of literature review about vein viewer have advantage to process of venipuncture in children. Based on these results, the authors suggest to use of vein viewers in all rooms in the hospital to perform venipuncture measures in children, and suggest conducting research for further development related to existing vein viewer devices.

The Effect of Acupressure on Acute Pain During Venipuncture in Children: Implications for Evidence-Based Practice.

The study was conducted as a randomized controlled trial in order to determine the effects of acupressure on acute pain during venipuncture in children. The population of the study consisted of children, aged between 9 and 12years, who received venipuncture between September 2015 and June 2016 at a university hospital in Istanbul. The sample consisted of a total of 90 children, including 45 children in the acupressure group and 45 children in the control group, who met the sample inclusion criteria. The results of the study were obtained by using an information form, the State Anxiety Inventory for Children (STAIC), the visual analog scale (VAS), and the Faces Pain Scale-Revised (FPS-R). Acupressure was applied to the children in the acupressure group for 10min before the venipuncture procedure. Pain, heart rate, and oxygen saturation levels of the children in the acupressure and control groups were evaluated both before and after the venipuncture procedure. The children in the acupressure and control groups were found to be similar in terms of age, gender, parents' educational levels and working status, number of venipuncture procedures, and mean anxiety scores. In the evaluation that was conducted before the venipuncture procedure, no statistically significant differences were observed between the heat rates, oxygen saturation levels, and expected pain scores from the venipuncture procedure in the children in the acupressure and control groups. On the other hand, it was observed that the children in the acupressure group (VAS: 19.51±4.98; FPS-R: 2.08±0.41) experienced less pain than the children in the control group (VAS: 47.37±9.89; FPS-R: 4.84±1.08), and there was a significant difference between the two groups (p< .000). Acupressure administration is effective in reducing the pain that is experienced by children during a venipuncture procedure.

The Effect of Virtual Reality and Kaleidoscope on Pain and Anxiety Levels During Venipuncture in Children

PurposeThe study aimed to determine the effect of two different distractions on pain perceptions and anxiety during venipuncture in children. DesignA randomized controlled study. MethodsA total of 139 children aged between 4 and 10 years were included in the study: 46 of them in virtual reality goggle group and 43 in the control group. An information form, the Children’s Anxiety Scale, Visual Analogue Scale, and Wong-Baker Faces Pain Scale were used in the collection of data. FindingsPain and anxiety scores were significantly lower in the virtual reality goggle and kaleidoscope group than in the control group (P < .000). ConclusionsThe use of virtual reality goggle and kaleidoscope methods during venipuncture are effective in reducing children’s perception of pain and anxiety. The most effective method of reducing perception of pain and anxiety is using the virtual reality goggle.

Evaluation of an improved small gauge needle for venipuncture in children with difficult venous access: Impact on sample quality, phlebotomist satisfaction and patient pain perception

BackgroundSmaller needles gauge (G) may reduce pain and improve vein access in difficult venous access (DVA). Aims were to compare the performances of two Beckton-Dickinson (BD) Vacutainer® Blood Collection Sets in a pediatric setting: UltraTouch™ Push Button (UT-PBBCS) and Safety-Lok™ (SLBCS). Materials and MethodsQuestionnaires were used to record venipuncture features, patient pain perception and phlebotomist difficulty score. Specimen quality was evaluated by hemolysis index (HI) on Roche Cobas® 6000. ResultsSLBCS (21/23G) or UT-PBBCS (23/25G) were used in 211 (50.2%) and 209 (49.8%) subjects. Pain was associated with age (p < 0.0001) and was lower in UT-PBBCS (p = 0.0339). Difficulty was significantly associated with age (p = 0.002), not with needle gauge (p = 0.461) and it was 0.42 points lower in UT-PBBCS. HI was not associated with blood collection set (p = 0.385). ConclusionsUT-PBBCS globally performed better than SLBCS and could enhance phlebotomy and patient comfort, without affecting sample quality in pediatric patients with DVA.