Relieving pain during procedures in the emergency department (ED) is challenging but is an important and necessary element of providing quality care. Children in the ED is a somewhat unique situation because the caregivers, while attempting to comfort their children, are exposed to the psychological trauma of the painful procedure as well. This study examined the physiological and anxiety responses of caregivers while watching their child undergo intravenous cannulation. Caregivers were found to have a significant increase in heart rate, blood pressure, and anxiety while watching. The caregivers' distress and anxiety were found to account for a substantial portion of the variability in the child's distress and anxiety. Thus, comforting of the child must also include measures to reduce stress and anxiety in the caregivers, as well.