As far as the meds go...I usually let the parents do it or at least hold the child while I swirt in in the side of the cheek than I squeeze the cheeks together before they get the chance to spit it back at me. (its kind of hard to explain online). Sometimes this doesn't always work.
I can't help you with the throat swabs we don't do that many in in pt setting...usually you guys in the ER take care of that!
Ok I have a big issue with how most of the people in our er dress the IVS. We usually always have to redo them. We always use arm boards...it might be irriating to the kid but at least we dont lost the iv...
Then we put the immobilizer over that for the smaller kids that way they can't pick at it. (sorry for the bad spelling
!) Also, I hate it when an IV is wrapped with a bunch of kurlex...I hate having to unwrap all that crap so I can see the site. Its just a big mess when you cover the site with Kurlex! Be kind the inpt ward and don't but anything but a tegaderm over where the cannual is going in. I hate having to undress sites so I I see them...it takes the risk of losing a line in the kids. We try to min. the amt of sticks they get. We also used what is called bumper guards (just rolled up 2x2) on the each side of the cannual, but not over it!
As stated before, the best way to hold down a little wiggle worm is to wrap them up in a sheet with whatever limb sticking out that you are working on. It usually takes at least 2 people to hold a little one still for IVs and labs.
The biggest thing with kids is to get down on the same level as them and talk to them not at them or around them. Try to break the ice with them before you start doing a bunch of crap to them! Stickers/toys/prizes are always good ways to be forgiven for the bad stuff you have to do to the kids. Also, do the least invasive thing 1st then most invasive last.
Also, at my hospital if the er is having a hard time getting blood or a line on a kid they call us or the picu/nicu for help. We would rather you do that than poke the kid a million times and ruin any chance we have in getting a line!
Good luck with you peds pts!