Buzzy Versus Vapocoolant Spray: Pediatric Needle Pain Relief

Study Overview
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Brief Summary
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A vibrating cold pack placed proximal to the site of venipuncture will decrease the pain of cannulation when compared to vapocoolant spray.

Detailed Description
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Needle pain is the most common and the most feared source of childhood pain, resulting in needle phobia for 10% of adults. Current pain relief options include numbing creams, vapocoolant spray, or injected lidocaine. 17 million pediatric IV access procedures are done yearly with no pain intervention. An inexpensive, immediately acting form of needle pain control could reduce needle phobia in the long term if demonstrated to be effective for needle pain. This study will evaluate pain self report and parent report using the Faces Pain Scale revised, and video-coded OSBD-R scores for patients undergoing emergency department venous access or cannulation procedures. Demographic information, pre-procedural anxiety, and success data from the attempts at placement will be included.

Official Title
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Buzzy: An Integration of Vibration, Cold, and Distraction for Pediatric Needle Pain Relief

Conditions
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Pain

Intervention / Treatment
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* Device: Buzzy
* Other: vapocoolant


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients requiring venipuncture in a pediatric emergency department Informed consent Patient assent Exclusion criteria: Patients with sickle cell or other sensitivity to cold Nerve damage in the area Abrasion or break in skin where device would be placed Critically ill

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Standard Care<br>venipuncture with vapocoolant spray offered | Other: vapocoolant<br>* venipuncture with vapocoolant spray offered<br>* Other names: PainEase;|
| Experimental: Buzzy<br>Vibrating device with cold pack held to arm with tourniquet proximal to venipuncture site, optional distraction cards. | Device: Buzzy<br>* Buzzy is a vibrating cold pack attached with Velcro strap or tourniquet 5-10cm proximal to the site of venipuncture. The vibration is activated and the device remains in place throughout the procedure. The distraction cards are offered to the parents to show the children, with questions on the back and pictures on the front.<br>* Other names: BuzzyR;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Faces Pain Scale-Revised (FPS-R) | Self-report measure of pain via 6 faces ranging from neutral to increasing pain expression. The scoring for the scale ranges from 0-10 with lower scores representing lower pain and higher scores representing higher pain. The FPS-R was conducted several minutes following venipuncture. This time was not tracked, but it was typically between 2-5 minutes following completion of the venipuncture. | 5 minute | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| OSBD-R Observational Pain/Distress Scale | The Observational Scale of Behavioral Distress (OSBD) is a validated and commonly used scale. There are 11 OSBD distress responses (information seeking, cry, scream, physical restraint, verbal resistance, seeking emotional support, verbal pain, flail, verbal fear, muscular rigidity, and nervous behavior). Using videotapes of the venipuncture, a composite OSBD score of 1 (low distress) to 11 (high distress) was assigned from the time of placement of tourniquet to placement of the bandage or securing the intravenous line (IV) after the first attempt. Two students not associated with the hospital or the device had been previously trained in this methodology and coded all tapes. A supervisor assessed interrater reliability on each coded behavior. After each group of 10 subjects, interrater agreements that fell below the level of excellent agreement (kappa = 0.80) were reviewed and discussed by both coders, with the consensus score recorded and definitions of observed behaviors. | 5 minute | 
| Number of Participants With Venipuncture Success in One Attempt |  | 5 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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pediatric, venipuncture, pain, vibration, vapocoolant