184 - Pain Assessment during Intra Venous Cannulation of Children Admitted in Pediatric ward, Using Faces Pain Scale-Revised

Poster Number: 184
Publication Number: 184.317

Ayushi Mistry, Pramukh Swami Medical College, Nadiad, Gujarat, India; Satvik C. Bansal, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India; MAYUR SHINDE, BHAIKAKA UNIVERSITY, Anand, Gujarat, India; Somashekhar M. Nimbalkar, Bhaikaka University, Karamsad, Gujarat, India

Background: Peripheral intravenous (IV) cannulation forms an essential part of management of children requiring hospital admissions regardless of the underlying condition. Inability to effectively secure and maintain an intravenous cannula can lead to delayed delivery of IV therapy and increased cannulation attempts during hospital stay. Children with previous negative experiences of medical procedures are stressed and show a high level of anxiety before the subsequent needle-based procedures.

Objective: We determined the peripheral intravenous access practices prevalent in a tertiary care hospital of Gujarat. We also assessed grades of pain and practices to control it via Faces Pain Scale-Revised (FPS – R) during IV cannulation.

Design/Methods: Prospective observational study. IV cannulation, done as per routine medical management required in each patient, was observed and video recorded. Recordings were analyzed to determine pain grading using Faces Pain Scale-Revised (FPS-R). Patients with a GCS score of < 10 were excluded. STATA14.2 was used for analysis. Descriptive statistics [Mean (SD), Frequency (%)] were used to depict the profile of study participants and pain assessment using the FPS-R scoring system. Independent sample t-test and ANOVA were used to compare mean score of gender, and site of procedure, respectively.

Results: Pain during IV cannulation was assessed in 238 patients, of which 32.4 % (n=77) were females. Most lines were placed by nurses (50.8%; n=121), with rest by either resident (40.3%; n=96), or consultant (8.8%; n=21). Gloves were worn in 7.1% (n=17). An assistant was needed every time, and a tourniquet or local anesthetic were never used. The mean time for successful cannulation was 57.1 sec (±22.55 SD). A transilluminator device was used in all patients, to view the vein. Pain was graded at a minimum of 2 and a maximum of 10 (mean= 8.92 ± 2.1 SD). The difference in pain was not significant when compared between males and females ([8.78 ± 2.28 vs 9.08 ± 1.9]; p-value= 0.28). No significant difference in pain was found, when the site of IV cannulation was compared (left forearm [10±0.00] vs right forearm [9±2.13] vs left dorsum of hand [9±1.86] vs right dorsum of hand [8.84±2.24]; p-value=0.66). No pain control medications were used in any patient.Conclusion(s): Significant pain during IV cannulation was observed in our healthcare settings. Pain control interventions were not used. Education of health care workers on improving pain assessment during IV cannulations and pain management needs to be introduced in our healthcare setting.
Table 1Descriptive Analysis of Variables
Table 2Parameters studied