Child Restraint During Induction ?

[OR male nurse]

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 ?

[AussieRNinHI]

Im just inputting from my own experience, I have been an OR nurse for a while and, have worked in the UK, Australia and now the USA. I have seen a number of ways how a child is put to sleep. In one particular hospital I worked at, in the UK the pts are normally walk-ins, and for kids, one parent normally goes in with the child in the so-called "induction room". They sit on the parents lap, and normally the anaesthetist induces them with gas while the anaes. tech (known as the ODA-operating dept. assistant) is there ready to give a hand if needed. Once the child is asleep, there is a nurse on standby normally the circulator, who walks the parent out, while the anesthetist carries the child into the OR and the rest is done in there.

Back home in Australia, the hospital where i worked at,no versed/midazolam was given. Parents would come to the door with the child, escorted by a nurse from the ward or short stay.THe Anaesthetic nurse goes over the preop checklist at the door The child is taken into the OR by the anaesthetic nurse, and normally alot of "soothing" talk while being taken away from the parents..Normally there are 2 nurses (anaesthetic nurse and circulator) helping the anaesthetist at this point in the OR, one nurse or maybe 2 holds the child down, normally wrapped in a blanket so they can not move, and they are induced with Sevo, and all that crying helps put them to sleep quicksmart! once the child is asleep, one nurse holds the mask and ventilates, if needed..while the other nurse helps the anesthetist put th IV in. The child is then intubated.

Where I am now (US), the child is given versed before comming into the OR normally 10mins before, and it sure does do wonders! :)

[AussieRNinHI]

Oh and I forgot, in Australia, we use to do Anaesthetic clinic, so us nurses get to meet the patients, and we do all the preop stuff.. vital signs, ECG/EKG, explain what time they have to come in, when to fast etc etc, when we get kids, we normally explain to them beforehand what happens in surgery and we bring one of the paediatric circuits and show it to them.. and they can actually put on face so they know.. and parents normally are pretty good and remind them before surgery..it helps...

[Marie_LPN, RN, LPN, RN]

Wrapped in a blanket, halfway laying on them sometimes.