Child Restraint During Induction ?

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Wondering how the RN's hold a child still during induction. I've seen a couple of different ways. One way is the "smother" where you kind of throw yourself over the child and try to hold down their arms and legs if they are kicking and screaming. Another way I've seen is to place the child's arms under a blanket and hold the edges of the blanket down close to the child's body so they can't wiggle and grab the mask or pull out their IV. One of our Anesthesiologists is complaining about how we stop the child from wiggling where I work if we use the blanket technique. He is referring to some study that says it causes the child to be frustrated because they can't move their arms ? I thought it was the whole point so that the child can't grab the mask or pull out their IV ? So.. how do the rest of you hold down a wiggling screaming child when you are trying to mask induce ?

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Specializes in Ante-Intra-Postpartum, Post Gyne.

My trick is to have the parent hold them in their lap facing them with their legs around mom/dads waist with mom/dad harms pinning childs arms to side in a big bear hug and them sitting back in a chair to help keep legs pinned. This only work for injections of course and not I.V.s

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Hi,

I'm referring to putting a child to sleep in the OR. You have a child that is kicking and screaming when the mask is placed over their face. No parent present.

Thanks

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Hi,

I'm referring to putting a child to sleep in the OR. You have a child that is kicking and screaming when the mask is placed over their face. No parent present.

Thanks

Wouldn't it be easier to remedy the parent being present?

I know alot of hospitals are allowing parents into the OR until the child is fully sedated and they have the parents in the RR.

So the parent is the last thing they see, and the first thing they see.

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Wouldn't it be easier to remedy the parent being present?

So the parent can watch their child kick and scream when the mask is placed over their face ?

Also.. I have to correct my original post. I'm referring to smaller children where you mask induce. Once they are asleep you put in the IV.

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Specializes in Nephrology, Cardiology, ER, ICU.

Hmm - I did some intubations recently in the OR and the child was given a pre-op oral or IM sedative prior to being broiught back to the OR. Then...the child was quite relaxed and the CRNA just very easily was able to calm them. I observed from infants (>6 months to 8 y/o). The parents of the open heart kids were allowed back into the OR (fully garbed of course) to be with their kids until they were completely out. This worked well.

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Specializes in OR Hearts 10.

Also.. I have to correct my original post. I'm referring to smaller children where you mask induce. Once they are asleep you put in the IV.

A little PO Versed about 10 minutes before going to the room, then it's the smother technique if they are still kicking and screaming. Anes says the screaming (to a point) is actually a good thing since they are really sucking the gas at that time. The IV goes in after they are gassed down, then they are tubed.

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I've helped put many children to sleep. You give the child some oral versed pre-op and they are calm. The mask goes over their face and they go to sleep just as perfect as can be. I've seen it the other way as the child is just as calm as can be, the mask goes over their face and they start kicking and screaming. I really don't want my thread to be turned into a debate over how the parents should be in the room, etc. Most of these cases are children's dental cases where the parent is at fault for putting their child to sleep with a bottle of juice in the first place. I simply want to know how the other circulating RN's that actually work in the OR and know what I'm referring to restrain a kicking and screaming child during mask induction. Do you use a blanket to hold the arms still, do you lay over them and use a "smother" type technique. etc.

Thanks

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I used to do quite a bit of peds OR and I just held the child until they were mask-induced. And never had an issue one time without being able to control them. You can papoose them if you need to, but to hold them down fighting and kicking is not good for anyone.

Uusally a calming and soothing voice will work wonders, and this is from my experience.

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Specializes in OR Hearts 10.

Gotta love those dental cases. I was an oral surgery private scrub for 12 years before going to nursing school so when I first started here I was put in all the dental cases. Finally had to put my foot down and say I'm never going to learn anything else doing dentals 3 days a week.

The good news is our dental unit broke last month and there are no plans to replace it.:yeah:We have one fast dentist but 2 are really slow.

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So the parent can watch their child kick and scream when the mask is placed over their face ?

Also.. I have to correct my original post. I'm referring to smaller children where you mask induce. Once they are asleep you put in the IV.

No...the REASON they are kicking and screaming is because they are taken away from mommy and daddy and have a ton of people taking them into a strange place, surrounded by tons of activity, and they are trying to hold them down.

That scares a child to death!

If a parent is there, soothing them, holding them until the mask is in place, assuring them the mask isn't going to hurt them and to just breathe....to me, that sounds like alot less traumatic than anything you are describing.

Then once the child is asleep, the parent leaves and waits to be called to recovery, where the parent is again present so the child can see them first thing.

Also, when possible, arrange for a child to be taken into the OR so they can just see the room....alot less scary if they have seen it before.

Someone there needs to get more creative with the process.

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Specializes in Operating Room.

On a personal level, I have heard things like, "Time to put on your seat belt!" :)

....Or...Breath into this....it will make you giggly.....

I don't see why the parent can't hold the child, or be in the room, until the child is calm enough for full sedation.

Surely, if that child kicks and screams, then the parent has seen plenty of kicking and screaming at home.....

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