The Effect of Medical Clowns on Blood Pressure Measurement in Children Presenting to the Emergency Department
Palabras clave
Abstracto
Descripción
Blood pressure is measured in the triage amongst most children presented to the Pediatric ED.
There are many barriers to obtaining an accurate BP measurement in children, including inappropriate technique, lack of equipment, but also - pain, and the child's uncooperativeness or anxiety. The latter may even be accentuated in an ED setting.
These factors may lead to falsely elevated BP readings, which may provoke significant anxiety in children and families and possibly lead to a cascade of unnecessary investigation and consultations.
Additionally, an abnormal measured BP value routinely mandate an additional measurement attempt which itself may cause anxiety and restlessness among children, especially toddlers and infants, and prolongs the entire triage process.
The Second Task Force Report on Blood Pressure Control in Children emphasizes taking blood pressure measurements in a quiet environment, using a proper size cuff and using appropriate technique. Ideally, BP should be measured several times in a a relaxed child and in a quiet setting, however this scenario is nearly impossible in the ED, as demonstrated in a previous retrospective study that indicated that although BP was elevated in 52% of children who underwent triage blood pressure measurement in the ED, the measurement was repeated in only 38%.
In the past decade, there has been a rapid growth in the presence of therapeutic clowns in hospitals, particularly in pediatric settings. A recent study conducted in a pediatric ED in Israel has demonstrated the benefit of medical clowns in diminishing pain and anxiety during painful procedures being performed on children in the ED.
Previous studies conducted in our institute have demonstrated a beneficial effect on vital signs (blood pressure and heart rate) as a sign of decreased anxiety following the incorporation of a medical clown in a multisystem team caring for pediatric patient.
Blood pressure measurement among pediatric patients, although not a painful procedure, may cause a stressful reaction, prolonging the entire process and requiring additional attempts - making it a time consuming task in a busy ED.
A medical clown may have a beneficial effect on the pediatric patient by decreasing the stress reaction and may therefore shorten the entire process making it much more efficient.
The investigators are unaware of any studies conducted related to the effect of the use of medical clowns during ED blood pressure measurements in the triage.
fechas
Verificado por última vez: | 02/28/2019 |
Primero enviado: | 05/03/2017 |
Inscripción estimada enviada: | 05/03/2017 |
Publicado por primera vez: | 05/07/2017 |
Última actualización enviada: | 03/23/2019 |
Última actualización publicada: | 03/26/2019 |
Fecha de inicio real del estudio: | 08/05/2017 |
Fecha estimada de finalización primaria: | 05/31/2019 |
Fecha estimada de finalización del estudio: | 11/30/2019 |
Condición o enfermedad
Intervención / tratamiento
Behavioral: Medical clown
Fase
Grupos de brazos
Brazo | Intervención / tratamiento |
---|---|
Medical clown Medical clown will be present in the pediatric emergency department while assessing blood pressure during triage of patients. | Behavioral: Medical clown Blood pressure will be taken to children admitted to the pediatric emergency department with and without the presence of a medical clown. |
Blood pressure assessment Blood pressure will be measured by the medical center protocols. |
Criterio de elegibilidad
Sexos elegibles para estudiar | All |
Método de muestreo | Probability Sample |
Acepta voluntarios saludables | si |
Criterios | Inclusion Criteria: - Children aged 1 day to 18 years presenting to the ED. Exclusion Criteria: 1. Serious medical condition requiring emergent medical care or resuscitation 2. Parental refusal to participate in the study |
Salir
Medidas de resultado primarias
1. Accurate blood pressure assessment [10 min]