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Quickly inserting an intravenous (IV) catheter in a sick child can be difficult because the topical anesthetic takes half an hour to numb the area, according to a study which suggests that another alternative might be available for emergency care.
A report published online by Pediatric Emergency Care discusses the advantages of a vibrating device that can be used with a cold pack to insert an IV with no more pain than if the child had received topical lidocaine. The advantage? The vibrating device can be used quickly, while lidocaine can take 30 minutes to reach full effect.
"This is the first study to compare a vibrating cold device to topical lidocaine in reducing the pain and distress experienced by children during IV insertion," said study leader Debra A. Potts, RN, MSN, CPEN, nurse manager in the emergency medicine department at Children’s Hospital of Philadelphia (CHOP). "This is important because hospitalized children experience IV insertion as a very painful and stressful event, and they can have post-traumatic stress symptoms if their pain is not adequately controlled."
For the study, researchers compared results in 251 patients, ages four to 18, who presented to the CHOP ED with a parent or guardian and required an IV. The patients, none of whom were in severe trauma, were randomized into groups: one group receiving topical lidocaine (TL) and the other receiving the vibrating cold device (VCD), which is battery-powered and reusable.
Study authors analyzed the children’s self-reports of pain and anxiety and detected no significant differences between the groups. The time of completion for the IV procedure was significantly shorter for the VCD group compared with the TL group, however, with a median of 3.0 vs. 40.5 minutes.
The main advantage for the VCD is its shorter time of onset, according to Potts, who added, "We anticipate that using this device would enable nurses to insert an IV with little pain for the child at least 30 minutes sooner than using topical lidocaine."
She called for follow-up studies to further evaluate the device.