Korean J Leg Med.  2018 Feb;42(1):1-7. 10.7580/kjlm.2018.42.1.1.

Pediatric Deaths and Venipuncture

Affiliations
  • 1Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 2Medical Examiner's Office, National Forensic Service, Wonju, Korea. zzeva@naver.com

Abstract

Venipuncture is a routine and relatively safe and painless medical procedure, necessary for accurate diagnosis and treatment. However, given that pain related to medical procedures may have adverse effects for children, could venipuncture cause deaths in infants and children? We analyzed our cases of unexpected death after venipuncture and conducted a literature review on them. A vasovagal response to noxious stimuli may explain such a sudden death immediately after venipuncture, commonly presented as needle phobia, breath-holding spell, and reflex anoxic seizure in the literature, despite the fact that the current medical evidence is not enough to prove their casual relationship. In addition, pain prevention and management during medical procedure is incorporated in clinical guidelines for pediatric patients, because painful medical procedures negatively affect child development. Thus, prevention and management of pain related to medical procedure may be helpful to avoid an adverse vasovagal response to noxious stimuli from occurring.

Keyword

Phlebotomy; Sudden death; Phobia; Infant death; Autopsy; Forensic pathology

MeSH Terms

Autopsy
Child
Child Development
Death, Sudden
Diagnosis
Forensic Pathology
Humans
Infant
Infant Death
Needles
Phlebotomy*
Phobic Disorders
Reflex
Seizures

Reference

1. World Health Organization. WHO guidelines on drawing blood: best practices in phlebotomy. Geneva: World Health Organizaion;2010.
2. Walco GA. Needle pain in children: contextual factors. Pediatrics. 2008; 122:Suppl 3. S125–S129.
Article
3. Sokolowski CJ, Giovannitti JA Jr, Boynes SG. Needle phobia: etiology, adverse consequences, and patient management. Dent Clin North Am. 2010; 54:731–744.
Article
4. Jenkins K. II. Needle phobia: a psychological perspective. Br J Anaesth. 2014; 113:4–6.
Article
5. Legge LM, Kantoch MJ, Seshia SS, et al. A pacemaker for asystole in breath-holding spells. Paediatr Child Health. 2002; 7:251–254.
Article
6. McLeod KA, Wilson N, Hewitt J, et al. Cardiac pacing for severe childhood neurally mediated syncope with reflex anoxic seizures. Heart. 1999; 82:721–725.
Article
7. Cho EJ, Rho TH, Kim HY, et al. Recurrent asystoles associated with vasovagal reaction during venipuncture. Korean J Intern Med. 2000; 15:232–235.
Article
8. Lipton JD, Forstater AT. Recurrent asystole associated with vasovagal reaction during venipuncture. J Emerg Med. 1993; 11:723–727.
Article
9. Roddy SM, Ashwal S, Schneider S. Venipuncture fits: a form of reflex anoxic seizure. Pediatrics. 1983; 72:715–718.
10. Tizes R. Cardiac arrest following routine venipuncture. JAMA. 1976; 236:1846–1847.
Article
11. Smith RB. Cardiac arrest or bradycardia following venipuncture. JAMA. 1979; 242:142.
Article
12. Lucas RM, McMichael AJ. Association or causation: evaluating links between “environment and disease”. Bull World Health Organ. 2005; 83:792–795.
13. Neubauer J, Lecca MR, Russo G, et al. Post-mortem whole-exome analysis in a large sudden infant death syndrome cohort with a focus on cardiovascular and metabolic genetic diseases. Eur J Hum Genet. 2017; 25:404–409.
Article
14. Wilson-Smith EM. Procedural pain management in neonates, infants and children. Rev Pain. 2011; 5:4–12.
Article
15. Committee on Fetus and Newborn and Section on Anesthesiology and Pain Medicine. Prevention and management of procedural pain in the neonate: an update. Pediatrics. 2016; 137:e20154271.
16. The Hospital for Sick Children (SickKids). Guidelines for pain assessment and management for neonates. Toronto: The Hospital for Sick Children;2017.
17. Korean Medical Guideline Information Center [Internet]. Seoul: Korean Medical Guideline Information Center;2017. cited 2017 Dec 10. Available from: http://www.guideline.or.kr/.
Full Text Links
  • KJLM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr