Why Do Some Children Experience More Pain During PIVC Insertion?

Study Overview
Peripheral intravenous catheter insertion is one of the most common invasive procedures experienced by children, but pain can vary considerably between patients and procedures.

This secondary analysis examined 198 PIVC insertion attempts in 130 children under 16 years to identify patient, procedural and situational factors associated with high pain scores.

Key Findings
42.3% of children experienced a high pain score during PIVC insertion.
Repeated attempts were particularly important. Children requiring three or more attempts were substantially more likely to experience high pain.
Other factors independently associated with higher pain included:
- younger age;
- a previous negative PIVC experience;
- being highly distressed or resistant during insertion; and
- using the antecubital fossa for the first attempt.
Nearly all children requiring three or more insertion attempts experienced high pain, while children experiencing no pain all had successful insertion on the first attempt.

Implications
Improving first-attempt success is not only a technical goal — it is an important part of reducing pain and distress for children.
Early recognition of children at greater risk, particularly younger patients or those with previous negative experiences, could support earlier escalation to experienced clinicians, appropriate pain-relief strategies and techniques that maximise the likelihood of successful insertion.

Read more: https://doi.org/10.1111/jpc.70493

Authors: Amy L. Sweeny; Shane George; Clayton Lam; Bianca Goucher; Stuart Watkins; Lucy Dunstan; Peter J. Snelling