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Effect of active noise cancellation on pediatric peripheral intravenous catheter insertion: A randomized controlled
Eui Jun Lee1,2, Jin Hee Kim2, Jae Yun Jung1,2
1Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Insights
Active noise-canceling (ANC) earphones did not improve first-attempt success for pediatric peripheral intravenous catheter (PIVC) insertion. Exploratory analysis suggests potential benefits in complex cases, warranting further research.
Area of Science:
- Pediatric Emergency Medicine
- Medical Device Technology
- Clinical Interventions
Background:
- Pediatric emergency departments are noisy environments, potentially impacting procedural success.
- Peripheral intravenous catheter (PIVC) insertion is a common but sometimes challenging procedure in children.
- The efficacy of active noise-canceling (ANC) earphones in improving PIVC outcomes is unknown.
Purpose of the Study:
- To evaluate the effect of ANC earphones on the first-attempt success rate of pediatric PIVC insertion.
- To assess the impact of ANC earphones on procedure time during pediatric PIVC insertion.
Main Methods:
- A randomized controlled trial involving 202 children under 8 years old requiring PIVC insertion.
- Participants were randomized to operators using ANC earphones or a control group.
- Primary outcome was first-attempt success rate; secondary outcome was procedure time.
Main Results:
- First-attempt success rates were similar between ANC and control groups (89.5% vs 89.7%, p > 0.99).
- Overall procedure time reduction was not statistically significant (p = 0.089).
- Effect size estimates indicated potential time reductions in challenging scenarios, such as difficult venous access (Cohen's d = -0.39).
Conclusions:
- ANC earphones did not improve the first-attempt success rate for PIVC insertion among skilled operators.
- Exploratory analyses suggest a potential benefit in reducing cannulation time in complex cases.
- Further multicenter studies are needed to confirm these hypothesis-generating findings.
Background:
Noise in pediatric emergency departments can impair procedural performance. We evaluated the effect of active noise-canceling (ANC) earphones on the outcomes of pediatric peripheral intravenous catheter (PIVC) insertion.
Methods:
This randomized controlled trial included 202 children (<8 years) requiring PIVC insertion. Participants were randomly assigned to operators wearing ANC earphones or a control group without earphones. The primary outcome was the first-attempt success rate, and secondary outcomes included procedure time.
Results:
First-attempt success rates were similar between the ANC and control groups (89.5% vs 89.7%; p > 0.99). The overall time reduction was not statistically significant (p = 0.089; Cohen's d = -0.17). However, effect size estimates suggested relatively larger differences in challenging scenarios, including patients with difficult venous access (Cohen's d = -0.39) and those requiring multiple attempts (Cohen's d = -0.66).
Conclusions:
Among skilled operators, ANC earphones were not associated with an improved first-attempt success rate. Exploratory analyses suggested a potential signal of reduced cannulation time in more complex situations; however, these findings were hypothesis-generating and require confirmation in larger, multicenter studies.
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