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Important Risk and Safety Information for Gebauer’s Pain Ease® and Gebauer’s Ethyl Chloride®:

Do not spray in eyes. Over spraying may cause frostbite. Freezing may alter skin pigmentation. Use caution when using product on persons with poor circulation. The thawing process may be painful and freezing may lower resistance to infection and delay healing. If skin irritation develops, discontinue use. CAUTION: Federal law restricts this device to sale by or on the order of a licensed healthcare practitioner.

Gebauer’s Pain Ease Only:

Apply only to intact oral mucous membranes. Do not use on genital mucous membranes. Consult your pediatrician when using on children 4 years old and younger.

Gebauer’s Ethyl Chloride Only:

Published clinical trial results support the use in children 3 years of age and older. Ethyl chloride is FLAMMABLE and should never be used in the presence of an open flame or electrical cautery equipment. Use in a well-ventilated area. Intentional misuse by deliberately concentrating or inhaling the contents can be harmful or fatal. Do not spray in eyes. Over application of the product may lead to frostbite and/or altered skin pigmentation. Cutaneous sensitization may occur, but appears to be extremely rare. CAUTION: Federal law restricts this device to sale by or on the order of a licensed healthcare practitioner.

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Patient Comfort in Trauma-Informed Care | Gebauer

By: Morgan O'Leary | On: May 31, 2023
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Patient comfort is a known factor that can help or hinder medical outcomes.

When pediatricians and pediatric nurses speed through appointments, patients’ fears may increase, their cooperation may be impaired, and they may even experience more discomfort. Having a child life specialist on board can add extra support to both the child, child’s family, and medical team to ensure that patient trust and comfort, critical components of trauma-informed care, remain at the forefront.

See how Gebauer’s Pain Ease topical anesthetic skin refrigerant can improve patient comfort in pediatrics. Download the guide.

How Does Patient Comfort Contribute to Outcomes? 

Patients who are comfortable are more likely to recover quickly. Pain triggers stress and anxiety, which can lead to higher levels of cortisol and suppression of the immune system. Both factors are connected to delayed wound healing1. Conversely, sufficient pain management is linked to several factors that might indicate that patient comfort measures may improve clinical outcomes, including shorter hospital stays and increased patient satisfaction.

Patient comfort is more than taking away physical pain or discomfort. It encompasses a sense of emotional security and well-being. Anxiety about treatment, perceived lack of support from healthcare professionals, and even inadequate family support can negatively impact recovery. Healthcare providers can make a significant difference by addressing these concerns and implementing measures to minimize discomfort, like offering pain relief even during minor procedures. This simple act goes a long way in reducing fear and anxiety, fostering patient compliance, and building trust in the healthcare system.

What is Trauma-Informed Care?

Medically, trauma refers to severe injuries that result from an outside force – such as a car crash, fall, or burn – often requiring hospital-based treatment. Psychologically, the definition of trauma is harder to pinpoint. Just as the perception of pain is subjective (whatever the patient says it is), trauma and distress are internal states, deeply felt. They involve not only what the patient has experienced but also how they process and interpret it.

This blog discusses trauma from a psychological perspective and how routine medical procedures can either elicit traumatic memories in a patient or provide a foundation for trust and comfort.

Trauma-informed care is a patient-centered framework that aims to provide support to patients so that they feel safe during their medical procedures – even if they have not disclosed a history of trauma to the medical staff. Healthcare providers collaborate with other professionals, such as child life specialists, to offer support during the encounter with the patient to minimize fear and anxiety and to increase comfort.

Providing trauma-informed care during every appointment is vital, not optional. Patients come to health care settings with a wide range of coping skills and prior experiences. Some, but not all, may have had sufficient support to alleviate the stress of medical treatment. Others may carry traumatic memories. Most likely, the health care team will not be able to simply look at a child and determine who needs additional care, attention, or encouragement. And children typically lack the verbal skills to explain their fears and anxieties.

If teams are oblivious, or too rushed, to attend to those needing more support, patients may greatly struggle during their appointments or feel unsupported by their physician or nurse. Such negative encounters can lead to children or their parents delaying or evading preventative healthcare, including vaccinations and blood tests, in the future. 2 The memory of how one felt can have serious, and lasting, consequences.

To improve patient comfort, medical professionals should work with child life specialists to find simple, efficient ways to provide support and comfort. As a result, patients may leave with a sense of wellbeing, rather than disappointment, following each health visit. And this positive feeling may prompt a greater likelihood to return.

What Does Trauma-Informed Care Look Like?

At its foundation, trauma-informed care is high-quality, patient-centered care rooted in safety, respect, and trust. Additionally, it focuses on helping the patient manage distress and emotions such as fear and anger. Nurses and child life specialists can work in tandem to promote trauma-informed care. For example, the nurse conducts appropriate procedures in which they have been well trained as the child life specialist utilizes their own training in child development to provide extra support needed in a potentially stressful encounter.

Needle procedures are an excellent example of how the pediatric staff and the child life specialist can work together to provide trauma-informed care. According to research in Family & Community Health, patients who have experienced trauma report that they feel fear and anxiety about medical procedures, particularly ones involving needles and injections.3

When a child is getting ready to have a needle procedure, the nurse can follow effective, routine protocol, using the patient’s name, asking for permission to touch them, and maintaining eye contact. The child life specialist also can play a vital role, providing a developmentally appropriate explanation of the procedure and why it is needed. Nurse and child life specialist can collaborate to assess the child’s pain and manage it appropriately and creatively, using breathing techniques, cold sprays, and visual distractions. They can also reassure the parents or caregivers that the needle procedure is necessary, and pain should be short-lived and minimized by pain management techniques.

After the procedure, the child life specialist can assist the child and their family manage any lingering anxieties by offering coping strategies and supporting the parents with useful advice. Ongoing assessment of the family’s needs after the appointment can connect them to social services that can provide additional support.

Benefits of Trauma-Informed Care

Patient-centered care and trauma-informed care share many benefits. Trauma-informed care helps medical professionals provide more empathetic service. Research has found a positive correlation between physician empathy, patient satisfaction, and clinical outcomes.4 When patients feel that their physician is being empathetic, they are more likely to trust and communicate freely. With more trust, children – as well as their caregivers – are also more likely to share relevant health information, rather than holding back. As a result, doctors are better able to provide precise diagnoses and promote adherence to their treatment plans.5

Building a Trauma-Informed Patient Comfort Toolkit

While traditional patient comfort kits focus on offering tools for physical pain relief and distraction, they often overlook the emotional impact of medical procedures. The trauma-informed comfort toolkit addresses this gap by prioritizing the emotional well-being and individual experiences of each patient. By incorporating the following key elements into a patient comfort plan, healthcare providers can create a more supportive and empowering experience for all:

  • Recognizing and Responding to Trauma: Recognizing the signs of trauma is critical. Equip the team to identify potential triggers and have a plan in place to address them. This may involve collaborating with Child Life Specialists or other qualified professionals to offer trauma-informed mental health screenings and connect patients with necessary community resources.6
  • Poke Plans for Peace of Mind: Develop clear, collaborative "poke plans" tailored to individual needs. Partner with patients to create a roadmap for managing stressful procedures like vaccinations and blood draws. Proven distraction and relaxation techniques can significantly impact patient comfort during appointments. Engage with patients by discussing their interests, offering age-appropriate videos, or guiding them through calming exercises. These strategies help shift focus and promote a sense of control, easing anxiety and facilitating positive experiences.
  • Physical relief: While pain relief is important to any patient, remember that for individuals with trauma histories, a needle's sting can trigger painful memories. Offering topical anesthetic sprays can offer immediate relief and demonstrate empathy for their anxieties. Topical anesthetic skin refrigerants, like Pain Ease, are ideal in these circumstances because they work immediately to temporarily control pain, do not require a physician’s order, and are a non-drug option. This small gesture speaks volumes, conveying commitment to creating a safe and supportive environment.

A trauma-informed approach goes beyond just tools; it's a philosophy that prioritizes understanding and respect. By incorporating these elements into a patient comfort toolkit, healthcare providers can create a more positive and empowering healthcare experience for everyone.

Add Pain Ease to Your Patient Comfort Toolkit

Using a topical anesthetic prior to immunizations, IV starts or other minor procedures is one way to improve patient comfort, especially for pediatric patients. Gebauer’s Pain Ease works within 10 seconds to control pain, easing the fear of needles. It’s easy to use in both hospitals and clinic settings because it’s non-flammable and doesn’t require a doctor’s order.

To learn more about using Pain Ease and other tactics to ease needle anxiety for children, download our eBook.

Citations

  1. https://medicalethics.me/wp-content/uploads/2018/09/Pain-as-contributor-to-delayed-healing.pdf.
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4900413/
  3. https://www.brighamandwomens.org/assets/BWH/womens-health/connors-center/pdfs/tic-in-medicine-raja-2015.pdf
  4. https://bjgp.org/content/63/606/e76
  5. https://link.springer.com/article/10.1007/s11845-019-01999-5
  6. https://www.nctsn.org/treatments-and-practices/screening-and-assessments/trauma-informed-mental-health-assessment