The Effect of a Medical Clown on Pain During Intravenous Access in the Pediatric Emergency Department

Background. We report the effect of the presence of a medical clown during insertion of an intravenous catheter during their emergency department visit. Methods. Prospectively randomized to either the presence or absence of a male medical clown during the procedure. Pain was assessed using the Faces Pain Scale–Revised in children 4 to 7 years old, and visual analog scales in children 8 years and older. Parental situational anxiety was recorded using the State-Trait Anxiety Inventory after the procedure. Results. The presence of a medical clown during a painful procedure in the pediatric emergency department tended to improve pain scores in children younger than 7 years. Parental situational anxiety was significantly reduced in parents of children older than 8 years (P = .02). Conclusion. Therapeutic clowns are useful for diminishing pain and anxiety during painful procedures being performed on children in the emergency department.