IVs/blood draws

Specialties Pediatric

Published

So I work in the ER, not a pediatric ER...but we do get pediatric patients. Most of the time they come in with a fever with asthma exacerbation, but sometimes we get kiddos that come in for BH evaluations or dehydration. Sometimes the providers order an IV and routine labs. I try to avoid sticking kiddos if I have to because honestly, I dread it. I think part of it is because I don't really know how to approach them when I have to draw some blood or start an IV. The other part is I don't want to them cry or scream at the top of their lungs.

The youngest patient I stuck so far was a 10 year old. Routine labs for a BH workup. I brought another nurse in to help hold her down. I told her we have to get some blood and she freaked out a little but after some coaxing from mom (and having her arm held in place by the other nurse) I was able to draw all my tubes with no problem. The child did a great job and I told her she was being so brave. That wasn't as bad as I thought it would be. I'm more so worried about the younger ones.

So, how do you approach kiddos when it comes to this?

Specializes in Pedi.
To whoever said 10 is too old to hold down, some children have had traumatic events happen where needles absolutely terrify them. A couple of children very close to me were traumatized by a dentist who claimed they had cavities and needed to remove them right then and there. The dentist injected anesthesias into their gums and the screamed and cried for the dentist to stop, but the dentist told them it didn't hurt and they needed to stop. Now one of these children has to be held down when getting immunizations at check ups...

BTW another dentist they were referred to said they did not have any cavities, so watch out for those dentists!!

And holding this child down to further traumatize her is going to help how? Kids who have had these experience more especially should NOT be held down.

I stand by my original statement and it was in response to the OP's statement "The youngest patient I stuck so far was a 10 year old. Routine labs for a BH workup. I brought another nurse in to help hold her down." It sounded like she walked in to stick a 10 year old and automatically brought reinforcements to hold the child down. A typically child of that age IS too old to "hold down". OP clarified that the other nurse was more just holding her arm still which may have been appropriate.

Specializes in Medical Surgical.

I am just saying, think about it. Even older kids can be scared of needles to the point that they won't sit still even for an immunization. But it is one of those things that has to be done... Everything is not so black and white. There are variables to everything.

Specializes in ER, progressive care.

Ashley, thank you so much for your tips!

Sadly, I do sticks on as many as 10-14 pedi pts a shift. Many times we start IVs right at the start.

Here is what I have learned in the last few years:

1. First and foremost-be honest. I need to develop some kind of trust with the child. I NEVER lie to the child. If they ask if ti is going to hurt

2. Spend time finding the best place for the stick. Try to do this before discussing that they are going to stuck. I avoid the AC when starting IV whenever possible.

3. Once you find a good site, (or as good as it is going to get), then get with it and get the job done. By now the pt has seen the needle and is getting scared, do not make them wait!

4. NOBODY likes sticking kids, nobody. suck it up and just get the job done. Yes, you are going to miss more often that not. Sorry, but that is just the way it is. If you succeed 50% then you are better than most. If you do not try, then you will never get good.

5. If you're really scared, then start with the smallest child you can. Surprisingly enough, it is a LOT easier to start an IV on a 3-4 pound baby than a 20-30 pound kid.

Try Buzzy pediatric pain control. Its a neat little gadget that doesnt need a doctors order. just google "buzzy pediatric pain control"

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