Effects of Rapid Vaccine Injection Without Aspiration and Applying Manual Pressure Before Vaccination on Pain and Crying Time in Infants

• Published in: Worldviews on evidence-based nursing 2017-04, Vol.14 (2), p.154-162
• Main Authors: Gol, Ilknur, Altu Ozsoy, Suheyla
• Format: Article
• Language: English
• Subjects: Babies; Clinical trials; Crying; Evidence-based nursing; Female; Humans; Immunization; Infant; infants pain; Injections; Injections - nursing; Injections - standards; Male; manual pressure; Medical procedures; needle aspiration; Pain; pain control; Pain Measurement - methods; Paracentesis - nursing; Paracentesis - standards; Time Factors; vaccination; Vaccination - methods; Vaccination - nursing
• ISSN: 1545-102X; 1741-6787; 1741-6787
• DOI: 10.1111/wvn.12206

ABSTRACT Aim To compare effects of rapid injection without aspiration and 10‐second manual pressure before injection on pain severity and crying time in 4‐ to 6‐month‐old infants given the vaccine DTaP/IPV/Hib. Methods This is a randomized double‐blind controlled study. The study population included all the infants presenting for DTaP/IPV/Hib to two family health centers between April and August in 2015. The study sample included 128 infants based on confidence interval of 95% and statistical power of 80%. The sample was divided into four groups: manual pressure, rapid injection without aspiration, manual pressure combined with rapid injection without aspiration, and control groups. There were 32 infants in each group. Gender was adjusted in all groups. Stratified and block randomizations were used. Results Pain severity scores and crying time during and after the injections were significantly lower in the three intervention groups than in the control group (p = .001). The lowest increase in the mean heart rate during and after the injections occurred in the rapid injection without aspiration group (p < .05). In addition, the mean oxygen saturation before, during and after the injections was significantly lower in this group than in the other groups (p < .05). However, two infants in the rapid injection without aspiration group had low oxygen saturation levels starting before the injections. In fact, mean oxygen saturations did not change across time. This suggests that lower oxygen saturation in the rapid injection without aspiration group cannot be due to vaccines or the techniques used. Linking Evidence to Action Manual pressure and rapid injection without aspiration are effective and useful in relief of pain and reduction of crying time due to vaccine injections in 4‐ to 6‐month‐old infants.