An Evaluation of the Effectiveness of Local Anesthetics Used During Intravenous Catheter Insertion

Inclusion Criteria: * adult patients (aged 18 or older) * admitted to a general medical or surgical unit at Durham Regional Hospital (DRH) * have a physician's order for an IV * are able to speak, read and understand English * referred to the Vascular Access Specialty Team (VAST) at DRH for IV catheterization Exclusion Criteria: * admission to the emergency room, pre-op unit, an outpatient unit, a psychiatric unit, an intensive care unit, a pre- or postnatal care unit, or labor and delivery units; * history of a psychological disorder, as determined from the patient's chart; * history of peripheral neuropathy, as determined by patient's chart; * history of IV drug abuse, as determined from the patient's chart; * decreased sensation in the arm or hands, as reported in the chart or by the patient; * patient disorientation or confusion (i.e., unable to state person, place, time or unable to comprehend instructions for completing Visual Analog Scale); * a known allergy to lidocaine or benzyl alcohol as determined from the patient's chart; * veins that cannot be palpated and are difficult to visualize by VAST nurses; * pregnancy; * an order for the emergency insertion of an IV by the patient's doctor or assigned nurse; * an IV insertion that requires the use of a catheter gauged 18 or larger * severe vision impairment, as determined by the patient's inability to read the Visual Analogue Scale