The Use of Vapocoolant Spray for the Treatment of Minor Trauma in the Hospital Emergency Department

ABSTRACT

PURPOSE: Vapocoolant spray is used as an agent to relieve localized pain due to sport injury or intravenous cannulation. The aim of this study was to determine the effectiveness of vapocoolant spray in the treatment of minor trauma in a hospital emergency department. METHODS: We carried out a prospective randomized controlled trial of alert patients with minor trauma who visited our emergency department. The total of 90 participants, all over 14 years old, were divided into 3 groups: a 'NSAIDs IM' group (n=30), 'Vapocoolant spray' group (n=30), and 'NSAIDs IM with Vapocoolant spray' group (n=30). Patients rated their pain and satisfaction of treatment using a 100-mm visual analogue scale (VAS). We assessed pain by VAS 4 times: first upon arrival, and then at 15, 30 and 60 minutes after treatment. We also assessed their treatment satisfaction utilizing VAS at the point of discharge. In addition, we calculated the time between subject arrival and initial treatment. RESULTS: Groups did not differ significantly in terms of age or sex distribution. The mean of the VAS score did not differ significantly among the groups upon their arrival (p=0.885) and were observed as follows: 'NSAIDs IM' group 44.80+/-12.70 mm, 'Vapocoolant spray' group 45.20+/-10.49 mm, and 'NSAIDs IM with Vapocoolant spray' group 46.17+/-9.54 mm. At 15, 30 and 60 min after treatment, the mean reduction in VAS score significantly differed between groups (p<0.05). At 15 min after treatment the results were as follows: 'NSAIDs IM' group 5.27+/-3.26 mm, 'Vapocoolant spray' group 15.17+/-7.17 mm, and 'NSAIDs IM with Vapocoolant spray'group 14.57+/-4.07 mm. At 30 min after treatment the results were: 'NSAIDs IM' group 13.57+/-7.86 mm, 'Vapocoolant spray' group 19.47+/-9.96 mm, and 'NSAIDs IM with Vapocoolant spray' group 21.20+/-6.52 mm. At 60 min after treatment the results were: 'NSAIDs IM' group 25.73+/-8.07 mm, 'Vapocoolant spray' group 20.90+/-9.88 mm, and 'NSAIDs IM with Vapocoolant spray' group 28.93+/-6.66 mm. Satisfaction of treatment and initial treatment time differed between groups (p<0.05). For satisfaction of treatment, the median of VAS significantly differed between the 'NSAIDs IM' group and the 'NSAIDs IM with Vapocoolant spray' group [46.50(41-52) mm vs. 57.00(51-62) mm, p<0.0167]. Initial treatment time significantly differed between the 'NSAIDs IM' group and the other groups [22.50(13-34) min vs. 10.00(7-20) min and 13.00(7-20) min, p<0.0167]. CONCLUSION: Vapocoolant spray is effective in reducing pain with minor trauma in the hospital emergency department. We can simultaneously improve the patient treatment satisfaction and reduce initial treatment time by using the vapocoolant spray.