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Efficacy of Flippits to Reduce Pain in Children during Venipuncture - A Randomized Controlled Trial
Larishisha Risaw1, Kavita Narang1, J S Thakur2
1National Institute of Nursing Education (NINE), Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Insights
Distraction cards, known as flippits, significantly reduced pain during blood draws in young children. This simple technique offers an effective way to manage procedural pain in pediatric patients.
Area of Science:
- Pediatric Pain Management
- Child Psychology
- Medical Procedure Efficacy
Background:
- Venipuncture is a common but painful procedure for children.
- Effective pain management strategies are crucial for pediatric care.
- Distraction techniques show promise in mitigating procedural pain.
Purpose of the Study:
- To evaluate the effectiveness of flippits (distraction cards) in reducing pain during pediatric venipuncture.
- To compare pain levels in children receiving distraction versus standard care.
- To assess the impact of distraction on children's behavioral and self-reported pain.
Main Methods:
- Prospective, non-blinded, randomized controlled trial with 210 children (4-6 years old).
- Intervention group used flippits during venipuncture; control group did not.
- Pain assessed using the Face Legs Activity Cry Consolability (FLACC) scale and Wong Bakers Faces Pain Scale (WBFPS).
Main Results:
- The intervention group showed significantly lower mean pain scores on the FLACC scale (2.75 vs. 3.24, p < 0.001).
- Parent and self-reported pain on the WBFPS was also significantly lower in the intervention group (p < 0.001).
- Children in the control group were 2.5 times more likely to experience severe pain (OR 2.5, p = 0.002).
Conclusions:
- Flippits serve as a simple yet effective distraction method for pain relief during pediatric blood sampling.
- Distraction techniques can significantly improve the experience of children undergoing venipuncture.
- This study supports the use of flippits as an adjunct to minimize procedural pain in young children.
Objectives:
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.