Winning Abstracts from the 2008 Medical Student Abstract Competition: Decreased Pain Of IV Catheterization Via Jet Injection
Authors: Matthew V Satterly, Anikumar N Vinayakan MD, Heidi M. Koenig MD
IV catheterization can be a painful procedure.
A 57 year old white female presented to the University of Louisville Outpatient Day Surgery Unit for a skin graft to her left lower extremity post dog bite and subsequent infection. During her routine pre-operative preparation, she was to have an intervenous catheter placed for administration of fluids and medication during and after her procedure. After expressing a dislike of needles, she elected to have delivery of local anesthesia via jet injection technology. The patient received 0.2ccs of 1% carbonated lidocaine via J-Tip; jet injection on the dorsum of her hand. An immediate 7 to 8 mm skin wheal was produced and with no delay an 18 gauge IV catheter was placed without incident. The patient reported no pain whatsoever (0 out of 10) for both the administration of lidocaine and the IV catheter placement.
With pain often referred to as the 5th vital sign and a JCAHO mandate to “recognize the right of patients to appropriate assessment and management of pain” minimizing the pain generated secondary to procedures or treatment administered by healthcare professionals is a high priority. Moreover, with roughly 10% of the population having some degree of “needle-phobia” jet injection avoids the need to subject patients to undue stress and discomfort. Initially developed for mass vaccinations, jet injection is gaining interest in a variety of arenas, from insulin delivery to local anesthesia for vasectomy. By also eliminating the risk of needle stick injuries and reducing sharps waste, jet injection offers a safer working environment for healthcare providers and a more humane experience for patients.
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