The effect of cold spray application on the pain in peripheral intravenous cannulation application

Background: The evaluation process of the patients that apply to emergency departments begins with the triage of patients. Diagnosis, treatment and planned interventions should be carried out within the prescribed time according to the patient's medical condition. After the first evaluation process in the emergency departments, peripheral intravenous cannulation (PIC) is applied to most of the patients. In recent years, the use of non-drug methods has come to the fore to prevent patients from experiencing pain during PIC procedure. However, the researched methods haven't been able to find a place in the emergency practices. Purpose: The aim of this study is to analyze the effect of the cold spray on the pain during the PIC procedure. Methods: The sample group of this prospective study was composed of 205 patients, who applied to Tokat Gaziosmanpasa Health Research and Application Hospital between the dates of 29th December 2018 and 29th January 2019. The data were collected through the use of the 8-question sociodemographic questionnaire, NRS (Numerical Rating Scale) and Beck Anxiety Scale. SPSS ready statistical package formwas used to calculate the data and p<0.05 was considered significant. Results: A total of 205 patients were included in the study, 62.9 % of those were female and 37.1 % were male. PIC with cold spray was applied to 105 of the patients included in the study, 87 % of those stated that they would prefer this application in the subsequent PIC attempts. The felt pain value of the patients who didn't receive cold spray was calculated to be 5,21±2,38, while the value for those who received cold spray was 2,00±2,04. The use of cold spray has been shown to reduce pain significantly. Regarding Beck Anxiety Scale values, no significant difference was found between the values of patients who did not receive cold spray application and those who did. There was found a significant difference in terms of pain felt between the patients who under received PIC procedure from left and from right antecubital regions (p<0.05). The difference in pain values was found to be significant according to the size of the iv cannulas applied to the patients. The pain value for 20-gauge iv cannula was calculated to be 4,04±2,62, while the pain value for 22-gauge iv cannula was 2,65±2,54. Conclusions: Our study has demonstrated that the application of cold spray is an effective method in reducing pain during PIC application. The benefits of cold spray method; being able to be stored at room temperature, its lack of direct contact to the patient during the application and not requiring post-application waiting renders this method more practical and feasible compared to other methods. Keywords: emergency, pain, cold spray, intravenous cannulation