Adolescents’ pain and distress during peripheral intravenous cannulation in a paediatric emergency setting

Abstract

The objective of the study is to investigate pain and distress experienced by a group of adolescents and children during peripheral intravenous cannulation in a paediatric emergency department. This cross-sectional study was performed between November 2019 and June 2020 at the paediatric emergency department of the Institute for Maternal and Child Health of Trieste, Italy. Eligible subjects were patients between 4 and 17 years old undergoing intravenous cannulation, split into three groups based on their age: adolescents (13–17 years), older children (8–12 years), and younger children (4–7 years). Procedural distress and pain scores were recorded through validated scales. Data on the use of topical anaesthesia, distraction techniques, and physical or verbal comfort during procedures were also collected. We recruited 136 patients: 63 adolescents, 48 older children, and 25 younger children. There was no statistically significant difference in the median self-reported procedural pain found in adolescents (4; IQR = 2–6) versus older and younger children (5; IQR = 2–8 and 6; IQR = 2–8, respectively). Furthermore, no significant difference was observed in the rate of distress between adolescents (79.4%), older (89.6%), and younger (92.0%) children. Adolescents received significantly fewer pain relief techniques.Conclusion: This study shows that adolescents experience similar pain and pre-procedural distress as younger children during peripheral intravenous cannulation. What is Known:• Topical and local anaesthesia, physical and verbal comfort, and distraction are useful interventions for pain and anxiety management during intravenous cannulation in paediatric settings. • No data is available on pain and distress experienced by adolescents in the specific setting of the emergency department. What is New:• Adolescents experienced high levels of pre-procedural distress in most cases and similar levels of pain and distress when compared to younger patients• The number of pain relief techniques employed during procedures was inversely proportional to patient’s age, topical or local anaesthesia were rarely used

Comparison of Animation Distraction Versus Local Anesthetic Application for Pain Alleviation in Children Undergoing Intravenous Cannulation: A Randomized Controlled Trial

“…There was no significant difference in VAS scores between the ages of the children and within each age group. Giorgio Cozzi et al found in their study that adolescent patients had high levels of pre-procedural distress and comparable degrees of pain and anguish to younger patients [ 18 ].…”

Virtual reality vs. tablet for procedural comfort using an identical game in children undergoing venipuncture: a randomized clinical trial

“…There is a broad consensus that medical routine procedures are not a pleasant experience. Blood sampling, one of the most common routine procedures, is associated with increased levels of anxiety and pain, especially when the patients undergoing venipunctures are children ( 1 – 3 ). This can lead to both immediate consequences, such as impeding timely diagnosis, and long-term effects, such as causing or intensifying medical avoidance due to traumatic experiences ( 4 , 5 ).…”