title: The effect of a medical clown on pain during intravenous access in the pediatric emergency department: a randomized prospective pilot study.
abstract: BACKGROUND
  We report the effect of the presence of a medical clown during insertion of an intravenous catheter during their emergency department visit.
  
  
  METHODS
  Prospectively randomized to either the presence or absence of a male medical clown during the procedure. Pain was assessed using the Faces Pain Scale-Revised in children 4 to 7 years old, and visual analog scales in children 8 years and older. Parental situational anxiety was recorded using the State-Trait Anxiety Inventory after the procedure.
  
  
  RESULTS
  The presence of a medical clown during a painful procedure in the pediatric emergency department tended to improve pain scores in children younger than 7 years. Parental situational anxiety was significantly reduced in parents of children older than 8 years (P = .02).
  
  
  CONCLUSIONS
  Therapeutic clowns are useful for diminishing pain and anxiety during painful procedures being performed on children in the emergency department.
authors.affiliation: 1Dana-Dwek Children Hospital, University of Tel Aviv, Tel Aviv, Israel.
authors.forename: Ido
authors.initials: I
authors.lastname: Wolyniez
authors.forename: Ayelet
authors.initials: A
authors.lastname: Rimon
authors.forename: Dennis
authors.initials: D
authors.lastname: Scolnik
authors.forename: Alejandro
authors.initials: A
authors.lastname: Gruber
authors.forename: Oren
authors.initials: O
authors.lastname: Tavor
authors.forename: Eli
authors.initials: E
authors.lastname: Haviv
authors.forename: Miguel
authors.initials: M
authors.lastname: Glatstein
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D002404:Catheterization / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010865:Pilot Projects; D011446:Prospective Studies; D011581:Psychological Tests; D016896:Treatment Outcome; D014925:Wit and Humor as Topic
keywords: emergency department; pain; pediatrics; procedure; therapeutic clown