title: Does Combined Use of the J-tip® and Buzzy® Device Decrease the Pain of Venipuncture in a Pediatric Population?
abstract: BACKGROUND
  Both 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.
  
  
  OBJECTIVE
  To 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®.
  
  
  METHODS
  Pediatric 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®.
  
  
  RESULTS
  With 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.
  
  
  CONCLUSIONS
  Patients 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.
authors.affiliation: USC, Keck School of Medicine, Department of Emergency Medicine and Pediatrics, Los Angeles, CA.
authors.forename: Y Liza
authors.initials: YL
authors.lastname: Kearl
authors.affiliation: LAC+USC, Department of Pediatrics, Los Angeles, CA; University of Texas at Austin, Austin, TX.
authors.forename: Sheryl
authors.initials: S
authors.lastname: Yanger
authors.affiliation: LAC+USC, Department of Emergency Medicine, Los Angeles, CA.
authors.forename: Sandra
authors.initials: S
authors.lastname: Montero
authors.affiliation: LAC+USC, Department of Emergency Medicine, Los Angeles, CA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Morelos-Howard
authors.affiliation: USC, Keck School of Medicine, Department of Emergency Medicine and Pediatrics, Los Angeles, CA. Electronic address: iaclaudius@gmail.com.
authors.forename: Ilene
authors.initials: I
authors.lastname: Claudius
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D004867:Equipment Design; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D059408:Pain Management / Q000295:instrumentation*; D010147:Pain Measurement; D010372:Pediatrics; D018962:Phlebotomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local
keywords: Gated pain theory; Lidocaine; Needle-free device; Pain management; Pain scale; Venipuncture