The use of the needle-free jet injection system with buffered lidocaine device does not change intravenous placement success in children in the emergency department. Acad Emerg Med 2015 Apr;22(4):447-51
Date
03/18/2015Pubmed ID
25779227Pubmed Central ID
PMC4641518DOI
10.1111/acem.12629Scopus ID
2-s2.0-84926675523 (requires institutional sign-in at Scopus site) 15 CitationsAbstract
OBJECTIVES: The needle-free jet injection system with buffered lidocaine (J tip) has been shown to reduce pain for intravenous (IV) line insertion, but its relationship with successful IV placement has not been well studied. This study aimed to determine if J tip use is associated with improved first-attempt IV placement success in children.
METHODS: This was a retrospective cohort study of children ages 1 to 18 years with need for emergent IV placement. Approximately 300 children were selected from each of three separate age groups: 1 to 2, 3 to 6, and 7 to 18 years. The standard treatment group (no device) included children with IV insertions from January 2009 through January 2010 with no J tip. The J tip treatment group (device) included children with IV insertions from December 2010 through December 2011 who received J tips. Successful IV placement on first attempt was the primary outcome. A chi-square test was used to compare the proportion of first-attempt success and logistic regression was performed to assess the effect of device use and patient age, sex, and race on first-attempt success.
RESULTS: A total of 958 children were identified, 501 in the no-device group and 457 in the device group. The most common diagnoses were vomiting or dehydration (30.3%), trauma or burn (20.0%), and infection (15.5%). Overall, first-attempt success was 69.0% and was similar between the no-device (68.7%) and device (69.4%) groups (p = 0.81). No difference in first-attempt success with the use of the device was found in any of the age groups. Multivariate analysis found that only age of 1 to 2 years was associated with lower odds of first-attempt success when controlling for patient characteristics and device use.
CONCLUSIONS: The use of the J tip did not affect first-attempt success for IV placement in children.
Author List
Lunoe MM, Drendel AL, Brousseau DCAuthor
Amy L. Drendel DO Interim Chief, Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentCatheterization
Child
Child, Preschool
Emergency Service, Hospital
Female
Humans
Infant
Injections, Jet
Lidocaine
Male
Pain
Retrospective Studies
