The effect of a medical clown on pain during intravenous access in the pediatric emergency department: a randomized prospective pilot study

Clin Pediatr (Phila). 2013 Dec;52(12):1168-72. doi: 10.1177/0009922813502257. Epub 2013 Sep 11.


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.

Keywords: emergency department; pain; pediatrics; procedure; therapeutic clown.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Anxiety / diagnosis
  • Anxiety / etiology
  • Anxiety / prevention & control*
  • Catheterization / adverse effects*
  • Child
  • Child, Preschool
  • Emergency Service, Hospital*
  • Female
  • Humans
  • Male
  • Pain / diagnosis
  • Pain / etiology
  • Pain / prevention & control*
  • Pain Management / methods*
  • Pain Measurement
  • Pilot Projects
  • Prospective Studies
  • Psychological Tests
  • Treatment Outcome
  • Wit and Humor as Topic*