Mrs Rebekah Ciampa1, Ms Ivy Gough1, Dr Amanda Yao1, Ms Megan Day1, Dr Yan Ni Loh1,2
1NSW Health, Sydney Local Health District (SLHD), Concord, Australia, 2Chris O’Brien Lifehouse, Camperdown, Australia
Biography:
Clinical Nurse Specialist working within the Palliative Care team at Concord Hospital in Sydney.
Abstract:
Background:
Subcutaneous medication administration is essential in symptom management in palliative and end-of-life care, particularly when oral routes are no longer viable. Intolerance to subcutaneous injections can significantly hinder effective symptom control. Traditional mitigation strategies such as ice or topical anaesthetics often prove impractical due to time constraints and the urgency of analgesia delivery. Recognising the successful use of vibration devices in other clinical settings, our team adapted a vibration neural distraction device for inpatient palliative care use.
Aims:
To describe the use and impact of a vibration neural distraction device in reducing pain and anxiety associated with subcutaneous injections in a palliative care patient with severe injection intolerance.
Methods:
A commercially available, waterproof, battery-operated vibration device (95 Hz, approx. $15 AUD) was trailed with a single patient experiencing significant pain and hypersensitivity to subcutaneous injections. The device was positioned 2–3cm above the subcutaneous cannula insertion site and activated prior to and during medication administration. Patient and nurse reported outcomes were collected including 11-point pain numeric rating scale, likert scales reporting feasibility and effect of use and qualitative feedback were collected.
Results:
The patient reported a reduction in injection-related pain from 10/10 to 3/10 with use of the vibration device. Staff reported the device was easy to use and decreased distress during subcutaneous administration. Qualitative feedback included:
–“I am less anxious and scared about the injections” (Patient)
–“I would recommend this to other patients” (Patient)
–“Patient more relaxed” (Nurse)
–“Patient more willing to accept subcutaneous medications” (Nurse)
Conclusions:
The use of a vibration neural distraction device significantly reduced pain and anxiety associated with subcutaneous injections in this palliative care patient. This low-cost, easily implemented intervention may offer a valuable adjunct to symptom management for patients with injection intolerance and warrants further exploration in broader clinical contexts.