Topical Vapocoolant-Associated Vaso-occlusive Event in a 10-year-old with Sickle Cell Disease.
Alekya Kothamasu, Matthew S MacDougall, Jocelyn Mallard and 1 others
PMID 34090800WHAT IT FOUND
A child with sickle cell disease had pain at an IV site during transfusion after IV placement and a cold anesthetic spray.
Warm packs, ketorolac, and acetaminophen with codeine were given. The authors think the spray may have triggered sickling, but cannot separate its role.
Key findings
01The authors concluded that the patient's pain after transfusion may be related to the topical anesthetic used.
02The authors think the cold vapocoolant spray may have caused local sickle cell vaso-occlusion independent of the transfusion.
03The authors suggest asking about sickle cell status before using cold sprays.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a case report, so it describes what happened to this patient and cannot show that vapocoolant spray causes vaso-occlusive pain. Other causes of pain during transfusion, such as transfusion reaction or IV site malfunction, were considered, but this case does not prove which cause was present. The authors' link between the spray and sickle vaso-occlusion is based on the case and known cold triggers, not on a controlled comparison. The patient also received IV placement, transfusion, warm packs, ketorolac, and acetaminophen with codeine, so the contribution of any one component cannot be separated.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that vapocoolant spray is proven to cause sickle cell vaso-occlusive pain. The patient also received IV placement, transfusion, warm packs, ketorolac, and acetaminophen with codeine, and this is a case report, not a tested intervention.