title: Efficacy of Flippits to Reduce Pain in Children during Venipuncture - A Randomized Controlled Trial.
abstract: OBJECTIVE
  To investigate the efficacy of distraction by flippits/distraction cards in relieving pain associated with pediatric venipuncture process in young children.
  
  
  METHODS
  This study was a prospective, non-blinded, randomized controlled trial. The sample consisted of 210 children aged 4 to 6 y undergoing phlebotomy in the sampling room of the Advanced Pediatric Center outpatient department and were randomly assigned to control and intervention groups. Latter were exposed to distraction using flippits/distraction cards during the procedure. Pain was assessed for both groups by using FLACC (Face Legs Activity Cry Consolability) behavior pain assessment scale. In addition, procedural pain was also assessed by Wong Bakers Faces Pain Scale (WBFPS) using children and parents' report.
  
  
  RESULTS
  Flippits (distraction cards) had a significant effect on behavioral response to pain in children during blood sampling as evidenced by lower mean pain scores in the intervention group (2.75 ± 0.97) as compared to the control group (3.24 ± 0.85) as per FLACC behavioral pain assessment scale (p < 0.001). Parents and self reported pain as per Wong Baker Faces Pain Scale was also lower in the intervention group as compared to the control group (p < 0.001). Odds of severe pain/discomfort (total pain score 7-10) were 2.5 times higher in controls as compared to the intervention group (OR 2.5; 95% CI: 1.40-4.45) (P 0.002).
  
  
  CONCLUSIONS
  The use of simple distraction technique using flippits can significantly relieve the pain associated with blood sampling in children.
authors.affiliation: National Institute of Nursing Education (NINE), Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Larishisha
authors.initials: L
authors.lastname: Risaw
authors.affiliation: National Institute of Nursing Education (NINE), Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Kavita
authors.initials: K
authors.lastname: Narang
authors.affiliation: School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: J S
authors.initials: JS
authors.lastname: Thakur
authors.affiliation: National Institute of Nursing Education (NINE), Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sandhya
authors.initials: S
authors.lastname: Ghai
authors.affiliation: National Institute of Nursing Education (NINE), Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sukhwinder
authors.initials: S
authors.lastname: Kaur
authors.affiliation: Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India. bhavneetsahul@gmail.com.
authors.forename: Bhavneet
authors.initials: B
authors.lastname: Bharti
mesh_terms: D001288:Attention; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D018962:Phlebotomy / Q000009:adverse effects / Q000379:methods*
keywords: Blood sampling; Children; Distraction; Flippits; Pain