All children presenting to the Pediatric Emergency Department at Bellevue Hospital are first triaged by the nursing staff. Triage includes documenting vital signs, a chief complaint, and a brief clinical assessment. The physician (resident, fellow, or attending) evaluates the patient and repeats a more extensive clinical assessment. Children with clinical evaluations and treatment plans that identify a need for needle insertion will be prepared for the procedure by a physician, nurse, and/or a Certified Child Life Specialist (CCLS). Preparation involves education and support to the parent and/or child before and during the procedure. The pre-procedure preparation is a part of the routine care for all children who present to the PED and require a procedural intervention.