Efficacy of ShotBlocker in reducing pediatric pain associated with intramuscular injections

Drago, Lisa A.; Singh, Sabina B.; Douglass-Bright, April; Yiadom, Maame Yaa; Baumann, Brigitte M.

doi:10.1016/j.ajem.2008.04.011

« Previous Next »American Journal of Emergency Medicine
Volume 27, Issue 5 , Pages 536-543, June 2009

Efficacy of ShotBlocker in reducing pediatric pain associated with intramuscular injections☆

Lisa A. Drago, DO
- Department of Emergency Medicine, University of Medicine and Dentistry of New Jersey- Robert Wood Medical School at Camden, NJ 08103, USA
- Corresponding author. Tel.: +1 856 342 2427; fax: +1 856 968 8426.
Sabina B. Singh, MD
- Department of Emergency Medicine, University of Medicine and Dentistry of New Jersey- Robert Wood Medical School at Camden, NJ 08103, USA
- Department of Emergency Medicine, St Christophers Hospital for Children, Drexel University College of Medicine Philadelphia, PA 19134, USA
April Douglass-Bright, MD
- Department of Pediatrics University of Medicine and Dentistry of New Jersey- Robert Wood Medical School at Camden, NJ 08103, USA
Maame Yaa Yiadom, MPH
- University of Medicine and Dentistry of New Jersey- Robert Wood Medical School at Camden, NJ 08103, USA
Brigitte M. Baumann, MD, MSCE
- Department of Emergency Medicine, University of Medicine and Dentistry of New Jersey- Robert Wood Medical School at Camden, NJ 08103, USA

Received 25 January 2008; received in revised form 1 April 2008; accepted 9 April 2008.

Abstract

Objective

The aim of the study was to determine the efficacy of ShotBlocker (Bionix, Toledo, Ohio) in reducing pediatric pain with intramuscular (IM) injections.

Methods

A prospective randomized controlled trial was conducted in children aged 2 months to 17 years who required an IM injection. Children were randomized to the no-intervention group or the ShotBlocker group. Demographic data and the number of IM injections were recorded. Perceived pain scores were obtained from nurses and caregivers using a 6-point Likert-type scale. Baker Wong Faces scale was used in children 36 months or older. Difficulty using the device was also rated by nurses on a 6-point scale.

Results

One hundred sixty-five children were enrolled with 80 in the no-intervention arm and 85 in the ShotBlocker arm. The mean age of children was 45 months and 56% were male. Perceived pain scores by nurses were higher for the no-intervention group (2.6 vs 1.8, P < .001) as well as by caregivers (2.6 vs 2.1, P = .04). Children aged 36 months and older (n = 64) did not report a difference in pain scores (1.5 vs 1.3, P = .6); however, in a subgroup of children 72 months or older, pain scores trended higher in the no-intervention group (1.3 vs 0.5, P = .051). Nurse-perceived difficulty of ShotBlocker use was low 1.39 (±1.1).

Conclusions

Nurses and caregivers noted lower pain scores in children assigned to the ShotBlocker group. These differences were not as evident when children rated their own pain.