Efficacy of EMLA Cream in Reducing Venipuncture Pain in a Shorter Application Time in the Pediatric Population

Venipuncture such as blood draw and intravenous (IV) access are commonly performed in the emergency department (ED) as a diagnostic and treatment intervention. The pain associated with these procedures is inadequately treated and poorly managed in the ED despite safe and effective topical anesthetics, which are available. Effective procedural pain management is essential in reducing physical pain and prevention of psychological and emotional trauma children experience with venipuncture. Research has been done and shows Eutectic Mixture of Local Anesthetics (EMLA) cream is fully effective after application of 60 minutes. However, a sixty minute application time might not be feasible in the ED. The purpose of the study is to evaluate if EMLA cream is as effective at 15 minutes and 30 minutes as it is at 60 minutes. This will be a quantitative, randomized, and One Way ANOVA design study. A convenience sample of 969 pediatric patients’ ages 5 to 12 years old who visit the Sharp Chula Vista Emergency Department (SCVED) will be utilized for this study. Samples will be categorized into three groups with different EMLA cream application times: group 1 at 15 minutes, group 2 at 30 minutes, and group 3 at 60 minutes. The Wong-Baker Faces Pain Rating Scale (WBFPRS) and patients’ heart rate (HR) will be used for pain assessment before and after EMLA intervention. The One-Way ANOVA test will be used to determine if there is a change in pain level and heart rate in the means of the three groups. The f-test statistic will be used to evaluate main effects. If a significance is found, a Bonferroni post hoc will be performed to determine which of the timed EMLA group means is different by comparing one group against the others. The study will use a significant level of p≤0.05 with a confidence interval of 95%.