Painful Procedures in the Emergency Department: A Distraction Intervention

The purpose of this study is to determine if the pain and anxiety that children experience when they have venipuncture procedures performed can be reduced by a video-based distraction and coping strategy intervention. An instructional video has been designed to educate parents and children about what is going to happen during the venipuncture procedure; to teach coping skills that can be used before and during the painful procedure; and to provide distraction during the procedure by using an entertaining video segment.

Approximately 168 children (6-12 years of age)who are seen in the IWK ED requiring venipunctures for blood collection or IV starts will be randomized. PArent and child training in distraction and coping strategies will be provided by means of a self-administered video-delivery via a portable DVD player. Fifty percent of the eligible participants will receive the distraction and coping strategies intervention and 50% will receive the standard medical care provided by the IWK ED. Those receiving standard care will be evaluated for outcome results and then be compared to the intervention group. It is expected that children who receive the intervention will report less pain and anxiety associated with venipunctures than those who receive standard care.

Inclusion criteria

Participants will be eligible for this study if they:

• are between 6-12 years of age
• are presenting in the IWK Emergency Department who require a venipuncture for blood collection or IV initiation.
• are able to read and speak english
• provide written parental authorization and verbal child assent

Exclusion criteria

Participants will be excluded for this study if they:

• are in critical condition as determined by ED staff
• are in significant pain for other reasons other than the venipuncture
• have severe cognitive delay
• who require sedation for the venipuncture as determined by the ED staff