title: Atraumatic care: EMLA cream and application of heat to facilitate peripheral venous cannulation in children.
abstract: The purpose of this study was to investigate whether the application of heat placed to a child's potential intravenous (IV) site after the application of EMLA Cream™ decreases vasoconstriction, therefore promoting atraumatic care in the hospitalized pediatric patient.   Venipuncture in children is a painful and frequently performed procedure. While use of EMLA Cream™ to reduce pain on insertion is a common practice with pediatric patients, no studies had measured venous size in relation to EMLA Cream™ and heat application. A descriptive quantitative design was used to examine the use of EMLA Cream™ and application of heat to facilitate venipuncture for peripheral venous cannulation. A convenience sample of 30 hospitalized Caucasian children, eight to twelve years old, participated. Vascular ultrasound directly measured the vein prior to and 1 hour after EMLA Cream™ application, as well as 2 minutes after heat application.   Mean vein measurements were 0.243 cm prior to EMLA Cream™, 0.205 cm after EMLA Cream™ applied for 1 hour, and 0.253 cm after two minutes of heat. There was a significant increase in vein visualization from pre-application of heat to post application of heat with a success rate of 80% with the first time attempt of IV insertion. Therefore, application of heat counteracts the adverse effect of vasoconstriction that occurs with EMLA Cream™ application, potentially increasing peripheral venous cannulation success rates.
authors: Akron Children’s Hospital, One Perkins Sq., Akron, OH 44308, USA. lhuff@chmca.org
authors: Lori
authors: L
authors: Huff
authors: Annette
authors: A
authors: Hamlin
authors: Diane
authors: D
authors: Wolski
authors: Tracy
authors: T
authors: McClure
authors: Aris Beoglos
authors: AB
authors: Eliades
authors: Laurie
authors: L
authors: Weaver
authors: Deb
authors: D
authors: Shelestak
mesh_terms: D000779:Anesthetics, Local / Q000627:therapeutic use*; D002648:Child; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008012:Lidocaine / Q000627:therapeutic use*; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D009824:Ointments; D010146:Pain / Q000209:etiology* / Q000517:prevention & control*; D018962:Phlebotomy / Q000009:adverse effects*; D011318:Prilocaine / Q000627:therapeutic use*
chemical_list: D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D009824:Ointments; D011318:Prilocaine; D008012:Lidocaine