Older Child Terrified of Blood/Needles

  1. I have a 13-year old son who goes into a complete panic attack if a doctor or nurse tries to draw blood from him. Background: when he was about 8 years old, the doctor suspected a thyroid problem and needed to draw blood. He was fine with the procedure and then approximately 15 minutes after the blood draw he was on the floor, white, cold, sweating, and very dizzy. Ever since then he REFUSES to let anyone near him with a needle to draw any blood. We've talked with him and tried to reassure him nothing works! At 13 he is able to understand the importance of certain medical tests - but it still doesn't help.

    At his physical this year, the doctor noticed petechiae on his legs and wanted to get a platelet count. FOUR big nurses tried to hold him down and they couldn't do it! They had even explained to him previously that is what they would do if he didn't comply. He's 5'9" and very strong. After about 1 hour, one of the nurses convinced him to let her get some "drops" of blood from his finger, but of course this is not an ideal method for obtaining blood for a platelet count. Fortunately, the pediatrician felt that the platelet count came back fine. The petechiae have gone away and no one is sure why he had them.

    What are your thoughts on a child this old being so terrified of this procedure? He just flat out refuses to let it be done. Of course if an adult refuses a medical procedure, then doctors and nurses have to respect that wish - but this is a child (even though he is bigger and stronger than me!). I'm afraid that if he ever got really sick - they would have to admit him to the hospital and put him under just to get his blood!
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  2. 18 Comments

  3. by   midwestRN
    Wow, I'm sorry things went so poorly. My daughter almost had to be held down to get her first Hepatits shot, but after it was over she thought it was nothing and we never had any more trouble. Young men seem to be more afraid of needle sticks than any other group. I wish I had some wonderful advice, but other than giving him some po med to relax him, nothing comes to mind.
  4. by   JailRN
    amblessing

    Well. I think that unless it s life threatening, I wouldn't push the issue. As adults, we have the right to refuse tx, and after what this poor kid went through, it might be ok to give him a break and let him be in control. (at least for a while) He may just end up hurting somebody, then he'd probably really feel bad.

    I he gets really sick, they'll figure out what to do. I;m sure he's not the only young man who has a phobia about this.
    Good luck.
  5. by   researchrabbit
    My son is 13 and also has a needle phobia. This includes vaccinations.

    We needed some normal controls here for a research study, payment $25 for a blood draw. He volunteered, then when the time came, trembled, cried and backed out.

    So, I gave him one of the needles to look at and touch (we use the little butterflies). I also gave him one of the regular ones to look at and touch. We talked about how much it hurt the time he stepped on glass and how this wouldn't BEGIN to hurt that much.

    I also took one of the tubes, opened it and filled it with water, then poured it into his cupped hands so he could see what a small amount it was, really.

    We went home without drawing blood and I had him think about being poked. When he was OK (more or less) with imagining it, then I described how it would happen while he visualized it.

    He was OK the following week after all this thinking. He let ME draw it. He got it done without flinching and without being held down AND got $25.

    He thinks that in the future, it won't be so difficult now, since this one was so easy.

    So...you might try some desensitizing (apparently just holding the needle was a big deal for my kid -- plus he could see the difference in gauge with the butterful). You might have him watch while YOU give blood or have your blood drawn.

    You might consider seeing if he'd let you do a draw since you're a nurse (my son said me doing it was helpful, he knew it would be in and out and no poking around).

    You might also think about a reward that he'd like that would add some encouragement to the deal.
  6. by   MPHkatie
    I occasionally work pediatric ER and have found most of the older kids who end up needing IV's are fairly ill and don't put up much protest, even kids who have in the past fainted while getting injections.
  7. by   eltrip
    Excellent idea, Researchrabbit!

    Have a great day,
    Joy
  8. by   researchrabbit
    Originally posted by eltrip
    Excellent idea, Researchrabbit!

    Have a great day,
    Joy
    Thanks Joy! Learned desensitization from watching one of the psychologists here at the university years ago who was working with a lady with a dog phobia...imagine a dog...look at pictures of a dog...have a dog on our floor but in a cage in another room...have the dog in a cage in the room...have the dog out of the cage but on the therapist's lap...pet the dog...hold the dog. Of course this took months, but it was wonderful to see the lady eventually hold the dog.

  9. by   amblessing
    Thanks Researchrabbit - maybe that'll do the trick, but he also hates the sight of the blood, so maybe instead of water I could use something red - like cherry kool aid or tomato juice Just a thought
  10. by   researchrabbit
    Originally posted by amblessing
    Thanks Researchrabbit - maybe that'll do the trick, but he also hates the sight of the blood, so maybe instead of water I could use something red - like cherry kool aid or tomato juice Just a thought
    My kid said just the thought of blood made him shakey and made his skin hurt, but he only screamed when he saw the needle.

    Whatever it takes to get the process started...

    Your son has to be at least a little comfortable with where you start the desensitization process.

    If needles are too scary, start with holding sewing pins. Or start with a butterfly needle INSIDE the package and have him hold the package (those butterflys are so small they are less threatening) and when he is ready, HE can open it.

    As for the blood...start with tomato juice, ketchup or cherry Koolaid and have him imagine it's blood. start slow and work up and do a little bit every day. You could even put some cherry koolaid inside a blood tube. If he has really good veins, have him look at his own veins and imagine the blood inside. Have him remember a little owie (say a scratch or a papercut) and remember what the blood looked like.

    He might have fun experiementing with a blood tube, a butterfly, and a glass of cherry koolaid -- he can see how they work and he can see how quickly the koolaid is sucked into the tube (and if he ruins a dozen butterflys getting used to them, well, it's worth it).

    The less mystery to the process, the easier it will be for him.

    Use your imagination and have LOTS of patience...he's got time to work it out. Work from where he feels comfortable, take it as slowly as he wants to take it.

    It took my kid about a week, but the lady with the dog took months...it's a very individual process.

    It might help if there's a reward at the end of it. Or little rewards at the end of the week for doing a little imagining about the process.
  11. by   KRVRN
    Try using EMLA, then if you DO work up to actual needle sticking, maybe it won't hurt and reinforce the fear. Just a thought...
  12. by   researchrabbit
    Originally posted by KRVRN
    Try using EMLA, then if you DO work up to actual needle sticking, maybe it won't hurt and reinforce the fear. Just a thought...
    GREAT IDEA!!!
  13. by   anitame
    EMLA works great! I put it on my daughter before a blood draw and she watched the whole thing. Didn't even flinch, not bad for barely four years old. The lab tech said EVERY kid should use it, he'd never seen anyone use it before. Maybe this would help, in conjunction with the desensitization thing.
  14. by   imenid37
    emla is a great idea. my 14 yr. old daughter has had jra since age 8 and that means lots of blood draws and even some intra-articular cortisone several times. she does not use emla anymore for blood draws but did up until 2 yrs. ago. it worked great. her dr. uses it for all the younger kids and older too 9if they want it). when my youngest was 3, she was breaking out in hives and needed labs, so we borrowed some of my other gal's emla. guess what. she was hard to stick, but no crying. we have even used it on pts. in l/d who dread blood draws and needles. the trick is to put it on about 1 hr. ahead of time for lab draws. good luck. also, what about some of the anti-anxiety meds dentists use before "nervous" pts. come in for procedures? maybe it would help.

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