The "cough trick:" a brief strategy to manage pediatric pain from immunization injections

Area of Science:

• Pediatric Pain Management
• Immunization Procedures
• Behavioral Interventions

Background:

• Routine immunizations can cause significant pain and distress in children.
• Effective, minimally invasive pain reduction strategies are needed for pediatric healthcare settings.
• The "cough trick" is a simple technique requiring minimal resources for parents, children, and staff.

Purpose of the Study:

• To investigate the efficacy of the "cough trick" technique in reducing self-reported pain during routine immunizations in children.
• To assess the acceptability and effectiveness of the technique from the perspective of children, parents, and nurses.
• To explore potential demographic moderators, such as race, influencing the technique's effectiveness.

Main Methods:

• A randomized, controlled, within-subject study involving 68 children aged 4-13 years undergoing immunizations.
• Participants performed a "warm-up" cough followed by a second cough during needle puncture.
• Primary outcome was self-reported pain, supported by parent and nurse reports; satisfaction was also measured.

Main Results:

• Initial analysis showed no overall effectiveness of the "cough trick".
• Post hoc analysis revealed statistically and clinically significant pain reduction for Hispanic white and non-Hispanic white children.
• The technique was not effective for non-Hispanic Black children, though participants and nurses found it acceptable.

Conclusions:

• The "cough trick" may be an effective pain reduction strategy for certain pediatric immunization scenarios.
• Effectiveness appears moderated by self-identified race, necessitating further investigation.
• Additional research is required to understand the racial disparities observed and refine the intervention.