When a child needs a blood draw, it can be a very scary and stressful experience, not only for the patient but for the family as well. The experience is intensified if the patient is being treated in the emergency room.
That’s why a group of clinicians at Women and Children’s Hospital worked together to conduct a clinical trial hoping to determine the best way to reduce the pain a pediatric or adolescent patient experiences during a routine or emergency blood draw.
Cristian Sirbu, PhD, research scientist at CAMC Institute, said that people who have adverse or traumatizing experiences with needles as children are more likely to develop a phobia of needles, referred to as blood-injection-injury (BII) phobia.
“About one in 10 patients seeking medical treatments reports an excessive fear of needles, mainly due to the anticipated pain,” Sirbu said. “This fear becomes a significant obstacle in delivering medical care when patients need blood tests or injections in our hospitals.”
The study tested a lidocaine/tetracaine patch, lidocaine cream and a placebo (a patch without actual medication administered). The results showed that both the patch and cream were significantly effective in reducing the pain a child experienced during the blood draw, and made the entire experience more bearable for everyone involved.
Patients who came to Women and Children’s were randomly placed into one of the three conditions of the trial. To measure the pain produced by the needle stick, children were asked to estimate the pain level before and during the procedure using the Faces of Pain Scale. The parent/guardian and a research observer completed evaluations based on observations of the anticipation, actual needle stick and the needle removal/bandaging involved in the procedure.
When using a topical anesthetic like the lidocaine patch and cream, the patient must wait 20-30 minutes for the numbing to take place before a lab technician can complete the draw. While this would extend a patient’s time in the ER or in the lab, a majority of the parents/guardians mentioned in their evaluations that they would be willing to wait the extra time and spend additional funds to ensure their child had the most pleasant experience possible.
“One of the things you always struggle with is trying to make this an inviting environment for kids,” said Andrew Weber, vice president and administrator at Women and Children’s Hospital. “We’re trying to create an ‘ouchless’ experience so patients don’t develop a fear of hospitals when they require invasive procedures like a blood draw or an injection.
“It’s become a standard in children’s hospitals,” Weber said.
Women and Children’s also utilizes other tools to reduce the stress and anxiety of blood draws. In the waiting room in the outpatient lab, videos continuously play to help children focus on something other than the impending procedure. In inpatient settings, Christi Bissett, child life therapist, uses anything from bubbles to images projected on walls to distract pediatric patients from invasive procedures.