Aim This single-center, single-blinded, randomized controlled intervention study investigated the impact of the undersea-themed examination table cover (UTETC) on the fear and anxiety experienced by children during electrocardiography (ECG) applications.

Material and Method The study was conducted between April 1 and July 31, 2022, in the Pediatric Emergency Department of a Training and Research Hospital in Ankara. The study included 80 children aged 3–12 years. Children in the experimental group underwent the procedure in the ECG room, using UTETC, while the control group underwent the routine procedure in the examination room. The entire process was video recorded. Video recordings were watched by two nurses who were independent from the study and data were collected using the Descriptive Data Form, Children Fear Scale, and Children Emotional Manifestation Scale.

Results There was no statistically significant difference in the descriptive characteristics of the study groups. The children who underwent ECG with the UTETC completed the procedure more successfully, and their levels of fear and anxiety during the procedure were lower than in the control group.

Conclusions The UTETC was found to be effective in reducing fear and anxiety levels in children aged 3–12 years during ECG applications in a pediatric emergency department.