title: Hand-held computers can help to distract children undergoing painful venipuncture procedures.
abstract: OBJECTIVE
  Needle-related procedures can be painful for children, and distraction provides ideal pain relief in blood-drawing centres. This study assessed the effectiveness of playing a computer game during venipuncture, compared with low-tech distraction by a nurse.
  
  
  METHODS
  We conducted this prospective, randomised controlled trial at the blood-drawing centre of a tertiary-level children's hospital in Italy. Half of the 200 children played Angry Birds on a hand-held computer while the other half were distracted by a second, specifically trained nurse who sang to them, read a book, blew bubbles or played with puppets. Pain was measured using a faces pain scale for children aged 4-7 years and a numeric scale for children aged 8-13 years.
  
  
  RESULTS
  The 200 children had a median age of eight years. Children reported significant pain in 16 cases (16%) in the hand-held computer distraction group and in 15 cases (15%) in the nurse-led low-tech distraction group (p = 0.85). The procedural success rate at the first attempt was not different in the two groups.
  
  
  CONCLUSIONS
  Playing a game on a hand-held computer meant that only one in six children reported pain during venipuncture, but it was not superior to being distracted by nurses.
authors.affiliation: Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
authors.forename: Franca
authors.initials: F
authors.lastname: Crevatin
authors.affiliation: Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Cozzi
authors.affiliation: University of Trieste, Trieste, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Braido
authors.affiliation: Blood-drawing Centre, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Bertossa
authors.affiliation: Blood-drawing Centre, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Rizzitelli
authors.affiliation: Blood-drawing Centre, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Lionetti
authors.affiliation: Blood-drawing Centre, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Matassi
authors.affiliation: Blood-drawing Centre, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
authors.forename: Dorotea
authors.initials: D
authors.lastname: Calusa
authors.affiliation: Clinical Epidemiology and Health Services Research Unit, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Ronfani
authors.affiliation: Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
authors.forename: Egidio
authors.initials: E
authors.lastname: Barbi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D059408:Pain Management / Q000379:methods*; D018962:Phlebotomy; D011446:Prospective Studies; D018910:Video Games
keywords: Children; Distraction; Hand-held computer; Needle pain; Venipuncture