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Assessment of pain and post-injection induration in children: A comparative study of cold application, manual
V Sasireka1, G Bhuvaneswari2, Shyamaladevi Babu3
1Department of Child Health Nursing, College of Nursing, Mother Theresa Postgraduate and Research Institute of Health Sciences, Puducherry, India.
Insights
Cold Application, Manual Pressure, and Shot Blocker effectively reduce pain and swelling from pediatric intramuscular (IM) injections. These simple, low-cost methods can improve children's injection experiences.
Area of Science:
- Pediatric healthcare
- Pain management
- Injection techniques
Background:
- Intramuscular (IM) injections are common in pediatric care but cause pain and distress.
- Non-pharmacological methods like Cold Application, Manual Pressure, and Shot Blocker aim to reduce injection discomfort.
- This study evaluated these methods against standard procedures for pain and adverse effects.
Purpose of the Study:
- To compare the effectiveness of Cold Application, Manual Pressure, and Shot Blocker against a standard procedure in managing pain and swelling from pediatric IM injections.
- To assess the impact of these interventions on pain perception, swelling, redness, tenderness, and lump formation.
Main Methods:
- A randomized controlled trial involving 40 children aged 9-11 years.
- Participants were assigned to Cold Application, Manual Pressure, Shot Blocker, or Control (Standard Procedure) groups.
- Pain was measured using the Wong-Baker Faces Pain Scale (FACES) and a 0-10 Pain Rating Scale; physical effects were assessed via an observation checklist. Data were analyzed using Chi-square tests and ANOVA.
Main Results:
- Manual Pressure and Shot Blocker groups reported significantly less pain than the Control Group.
- Cold Application and Shot Blocker groups showed significantly reduced swelling.
- No significant differences were observed in redness or tenderness, and no lumps formed.
Conclusions:
- Cold Application, Manual Pressure, and Shot Blocker are effective, low-cost strategies for minimizing pain and swelling during pediatric IM injections.
- These techniques can be integrated into routine practice by healthcare providers, schools, and community health centers.
- Further multicenter trials are recommended to investigate long-term outcomes, including compliance and psychological well-being.
Background:
Intramuscular (IM) injections are widely used in pediatric care but often cause pain and distress. Effective management is essential to improve children's healthcare experiences. Non-pharmacological methods, including Cold Application, Manual Pressure, and Shot Blocker, have been proposed to reduce injection-related discomfort. This study compared these methods with the standard procedure regarding pain perception, swelling, redness, tenderness, and lump formation in children.
Materials And Methods:
A randomized controlled study was conducted in 2023 among 40 children aged 9-11 years from schools in Puducherry, selected through multistage cluster probability sampling. Participants were allocated into four groups: Cold Application, Manual Pressure, Shot Blocker, or Control (Standard Procedure). Pain was assessed using the Wong-Baker Faces Pain Scale (FACES). Pain Rating Scale (0-10), while swelling, redness, tenderness, and lump formation were evaluated with a validated observation checklist. Data were analyzed using Chi-square tests and one-way Analysis of Variance (ANOVA) with post-hoc Tukey's test.
Results:
Significant differences emerged in pain and swelling between groups. Manual Pressure and Shot Blocker groups reported significantly less pain compared to the Control Group. Swelling was significantly lower in the Cold Application and Shot Blocker groups. No significant differences were found for redness or tenderness, and no lumps were observed.
Conclusion:
Cold Application, Manual Pressure, and Shot Blocker are effective, low-cost strategies for minimizing pain and swelling during pediatric IM injections. These findings suggest that healthcare providers, schools, and community health centers could integrate such techniques into routine practice. Future multicenter trials should explore long-term outcomes, including effects on repeated injection compliance and psychological well-being.
