Injection Considerations for Administering Endocrine Parenteral Therapies to Children

Introduction: Early diagnosis of chronic endocrine conditions requiring injectable treatment is common, and injections may cause children to experience uncomfortable feelings (e.g., pain and anxiety). No recent publications have comprehensively described good nursing practices for pediatric injections. This review identifies key factors that can facilitate improved injection techniques and ideal treatment options for children, with a focus on endocrine parenteral therapies. Methods: PubMed, Embase, and CINAHL were searched. MeSH search terms included “child,” “injections/methods,” “pain/prevention and control,” “pain management/methods,” “patient positioning,” and “analgesic/therapeutic use.” Literature related to interventions pediatric nurses can implement to decrease injection-related discomfort and other treatment factors that can minimize injection-related pain was included. Results: Nurses should build a strong rapport with the child and/or caregiver, as this can improve the expectations for the injection experience. Nurses can assist caregivers with selecting the most appropriate treatment and provide options that may reduce out-of-pocket costs. Before administering an injection, nurses should check the “Five Rights,” assess skin to select an appropriate injection site, and prepare skin for injection. Good injection techniques include: administration of room temperature medications, comforting positioning and holding of the child by the caregiver, distraction activities, and local anesthetic agents. In addition to using good pediatric injection techniques, nurses can partner with Certified Child Life Specialists when available to help alleviate the child’s anxiousness. Discussion: Pediatric nurses benefit from a broad understanding of pediatric injection techniques. Conclusion: Optimal pre-, during, and post-injection techniques, along with proper education and care, can reduce pain and anxiety in children, improve caregivers’ experiences, and prevent treatment delays.