Older Child Terrified of Blood/Needles

[amblessing]

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!

[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.

[MollyJ]

I like the ideas about desensitization and EMLA.

Your thirteen year old is not so far away from his 15 year old tetorifice booster (unless he had one since age 10) so to have some plan in mind wouldn't be bad.

How does he do at the dentist? What helps him at the dentist? Music? Distraction? Help him to build on a situation in which he has been successful with dealing with his anxiety in a health care setting.

OFTEN 13 year old's have great veins. Maybe you could put a tourniquet on him (with NO NEEDLES around) and let him feel his own vein and reassure him that he has an easy vein to find.

I remember a teen who was throwing a huge fit about getting a tetorifice booster and this little, older teeny (tall as she was wide) peds office nurse just had him put his arms around her and give her a hug, while we would give him the shot--and then he let us give him the shot. He had to bend down to give her the hug, but it became an atraumatic shot and that was wonderful

[amblessing]

He's great at the dentist. He's fine with shots and immunizations. The kid even gets allergy shots twice a week! It's just the thought and the actual procedure of a bodily fluid (blood) leaving his body! It doesn't matter if it's two tubes or two drops - he's on the floor!

[KRVRN, BSN, RN]

Did he have a traumatic experience where he got injured and bled a lot? Maybe that's why he fears the sight of blood?

[amblessing]

Originally posted by KRVRN

Did he have a traumatic experience where he got injured and bled a lot? Maybe that's why he fears the sight of blood?

Nope, he just doesn't like the sight of it. He once cut his finger at a friends house and it bled alot -- the mom called for me to come pick him up because she said he was "white as a ghost". Just really freaks him out. Guess he'll never be a surgeon:chuckle

[researchrabbit]

Ann, you just never know! :) When I was a kid, I was afraid of blood, horrible smells would make me throw up, and now I'm a nurse! (it only took me till I was 40) :)

It's probably why I have so much patience with my own needle-phobe...I was there!

[dianah, ASN]

EMLA not in our formulary, unfortunately. Have asked about it numerous times. . . some folks just don't get it.