• Y Liza Kearl, Sheryl Yanger, Sandra Montero, Elizabeth Morelos-Howard, and Ilene Claudius.
• USC, Keck School of Medicine, Department of Emergency Medicine and Pediatrics, Los Angeles, CA.
• J Pediatr Nurs. 2015 Nov 1; 30 (6): 829-33.

BackgroundBoth the J-tip® (a needle-free device for subcutaneous delivery of lidocaine) and the Buzzy® (a cooled, vibrating device to employ gate control to minimize procedural pain) have shown some efficacy in diminishing the pain of venipuncture.PurposeTo develop an optimal protocol for pre-venipuncture/IV start pain management by investigating the impact of adding the use of Buzzy® prior to the use of the J-tip®.ProceduresPediatric emergency department patients aged 1 month to 21 years were prospectively enrolled in Phase 1 (J-tip® only) then Phase 2 (Buzzy®+J-tip®) for analgesia prior to venipuncture or IV start. Age-appropriate pain scale scores were collected for the subsequent procedure, as well the administration of lidocaine via J-tip®.Main FindingsWith the combined intervention (phase 2), 14.2% of patients had a pain scale score >3 with venipuncture and 16.1% had a pain scale score >3 with application of the J-tip® itself. With no intervention for pain relief, 71% of patients experienced a pain scale score >3 for venipuncture. With the J-tip® alone (phase 1), 21% had a pain scale score >3 with venipuncture and 22.3% had a pain scale score >3 with application of the J-tip® itself.ConclusionsPatients receiving either intervention reported lower scores on pain scales during venipuncture or IV start than the no analgesia group. The combined intervention did not yield a significant decrease in scores on pain scale scores over the J-tip® alone.Copyright © 2015 Elsevier Inc. All rights reserved.

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