Procedural and Physical Interventions for Vaccine Injections

Taddio, Anna; Shah, Vibhuti; McMurtry, C. Meghan; MacDonald, Noni E.; Ipp, Moshe; Riddell, Rebecca Pillai; Noel, Melanie; Chambers, Christine T.

doi:10.1097/ajp.0000000000000264

Cited by 65 publications

(36 citation statements)

References 68 publications

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“…Evidence-based clinical practice guidelines also recommend combining these interventions to reduce vaccination-related needle pain. This includes applying topical anesthetics prior to vaccination; using breastfeeding or sucrose for infants; avoiding the supine position; holding for younger (aged B3 years) and sitting for older children, as well as the rapid injection of intramuscular vaccine without aspiration [86,91,127,128]. The authors recommended various distractions during vaccination, but these recommendations were less supported by the literature.…”

Section: Combination Of Strategiesmentioning

confidence: 92%

“…Moreover, during vaccination specifically, skin-to-skin contact and holding an infant reduced acute distress [91]. The upright position reduced self-reported fear in children [91]. A systematic review reported that, for older children and adolescents aged 2-19 years, distraction and hypnosis were effective in reducing pain and distress related to needle procedures, including venipuncture, intravenous line insertion, and vaccination [84,92].…”

Section: Non-pharmacological Management Strategiesmentioning

confidence: 97%

“…For intravenous insertion, a child in a sitting position held by his/her parent is thought to experience reduced fear, and the position is reported to reduce the child's body movements and improve work space [90]. Moreover, during vaccination specifically, skin-to-skin contact and holding an infant reduced acute distress [91]. The upright position reduced self-reported fear in children [91].…”

Section: Non-pharmacological Management Strategiesmentioning

confidence: 97%

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Managing Pediatric Pain in the Emergency Department

Bailey

Trottier

2016

Pediatr Drugs

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Far more attention is now given to pain management in children in the emergency department (ED). When a child arrives, pain must be recognized and evaluated using a pain scale that is appropriate to the child's development and regularly assessed to determine whether the pain intervention was effective. At triage, both analgesics and non-pharmacological strategies, such as distraction, immobilization, and dressing should be started. For mild pain, oral ibuprofen can be administered if the child has not received it at home, whereas ibuprofen and paracetamol are suitable for moderate pain. For patients who still require pain relief, oral opioids could be considered; however, many EDs have now replaced this with intranasal fentanyl, which allows faster onset of pain relief and can be administered on arrival pending either intravenous access or definitive care. Intravenous opioids are often required for severe pain, and paracetamol or ibuprofen can still be considered for their likely opioid-sparing effects. Specific treatment should be used for patients with migraine. In children requiring intravenous access or venipuncture, non-pharmacological and pharmacological strategies to decrease pain and anxiety associated with needle punctures are mandatory. These strategies can also be used for laceration repairs and other painful procedures. Despite the gaps in knowledge, pain should be treated with the most up-to-date evidence in children seen in EDs.

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Section: Combination Of Strategiesmentioning

confidence: 92%

Section: Non-pharmacological Management Strategiesmentioning

confidence: 97%

Section: Non-pharmacological Management Strategiesmentioning

confidence: 97%

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Managing Pediatric Pain in the Emergency Department

Bailey

Trottier

2016

Pediatr Drugs

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“…No research has yet reported effects of low frequency vibration (50-100 Hz) on CRS pain. Most of the published literature has focused on analgesia in the peripheral nervous system [30,31,[57][58][59][60], though some research has reported success treating temporomandibular disorder pain [61,62]. Low frequency vibratory inhibition of nerves associated with the parasympathetic nervous system may be partly responsible for the beneficial effects of treatment [63,64].…”

Section: Discussionmentioning

confidence: 99%

Multimodal Frequency Treatment for Facial Pain Caused by Chronic Rhinosinusitis: A Pilot Study

et al. 2017

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Chronic rhinosinusitis (CRS) is a common disease that affects over 200 million patients worldwide. CRS often presents with facial pain, which is considered an important criterion for the diagnosis of CRS. A single-arm clinical study was designed to test the effect of simultaneous high (1 MHz) and low frequencies (70-80 Hz) on facial pain in 14 CRS patients at the Sarah Bush Lincoln Health Center, Mattoon, IL, USA. We used two quality of life (QOL) instruments to test the effect of multimodal frequencies on patients suffering from CRS: the Brief Pain Inventory Short Form (BPI-SF), and the Sino-Nasal Outcome Test (SNOT-22). Mean BPI-SF severity scores improved by 0.80 points (Wilcoxon rank sum test p < 0.01) in all 14 patients. In patients with baseline facial pain (n = 9), the scores improved by an average of 1.5 (p < 0.01) points in the pain severity domain and by 1.4 points in the pain interference domain. Additionally, the mean improvement in SNOT-22 scores was 14.11 (p < 0.05), which is above the minimal clinically-important difference (MCID) of nine points. Our pilot study indicates that multimodal vibration frequencies applied over the facial sinuses reduce pain, possibly through the reduction of the inflammatory response and modulation of the pain receptors. This study suggests the possibility that combining different frequencies could have an enhanced effect on reducing CRS-related facial pain.

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“…27 Although the importance of separating age groups due to the changes in cognitive development has been highlighted in similar reviews, 20 only one review of Psychological interventions excluded studies with participants younger than 3 years old, 17 while several other relevant reviews failed to exclude studies on infants, with data including large proportions of infant reports (23-81%). 19,22,28 With these considerations in mind, we have chosen to review interventions conducted in apparently healthy, school-age children (age 4-15), that do not require training or parent / carer involvement and therefore are appropriate in mass vaccination settings.…”

Section: Introductionmentioning

confidence: 99%