IV Placement on Deaf Child

[nessa_5555]

When you are prepping a pediatric client for surgery, and you find out he is deaf, DO NOT place his IV in his hands! It is how he talks!

And when he comes out from surgery, do not tie his hands down because he is not trying to rip out his tube, he is trying to tell you he wants his mom (IN SIGN LANGUAGE).

I dont know how many times my client has come out of surgery with IV's in his hands and they are strapped down. Would anyone like an IV in their mouth and gagged coming out of surgery???

Sorry just frustrated.

[Tait, MSN, RN]

I think you need to write this up and submit it to your facility as well :)

Tait

[Cathylady]

Very sad. Is this child in the hospital often?

[nessa_5555]

He is coming up to 50 surgeries so far. Unfortunately I am his homecare nurse and do not get to see him before surgery at the hospital. Mom is a great advocate for him and tells the nurses that he is deaf and not to place the IV in his hands, but it always gets lost in translation and he comes out of surgery with an IV in his hand and restrained. Its so sad.

[Cathylady]

Why so many surgeries?

My daughter is working on her BSN and is scheduled to take a American Sign Language class (her choice, not required) for this very reason, in case she has to care for any patient that is hearing impaired and signs.

[Bobbkat]

I took ASL too. We were required by our school to either take a basic Spanish or basic ASL class for healthcare workers. Keeping hands unrestricted was pretty much the first thing that we learned in ASL.

I agree with the pp that this should be written up. This should not happen. If I was his Mother I would write 'do not put IV here' on both of his hands just prior to surgery. Nothing so bold that it would be distracting to someone he is speaking with later. Maybe easily removable pen.

[TDCHIM]

Oh this just breaks my heart. I can see my child in his place, terrified if that primary mode of communication were suddenly taken away. The inked-on warning for his hands doesn't sound bad. Maybe the hospital could give him a warning bracelet indicating his hands must be free at all times - perhaps one usually used for allergies? - just to draw the caregivers' attention?

[LNFNP18, MSN, NP]

I agree with the previous poster who suggested writing a little note about not putting IV's there... maybe even just write it in erasable marker on both of his hands or on his arms.... or even put a pair of gloves on his hands (not the big bulky kind! Smaller ones so he can still communicate with his hands), with that written on them. I don't know... I'd be very concerned if this was my child that it was happening too. Best of luck!

Liz

[PostOpPrincess, BSN, RN]

It should be avoided at all costs, however, it is up to the anesthesia team wherever they can find the IV.

Unfortunately, it is IMPERATIVE he get his sedation/anesthesia and if his IV is at all compromised, it can become an issue.

Unfortunately for you, the priority in the operating room is NOT where is IV is, but there is a good, working one.

J

[Purple_Scrubs, BSN, RN]

That makes me sad.

[mamamerlee, LPN]

Tell the mom that she needs to speak to anesthesia pre-op. Children have veins in other places. Call the facility, if possible, and talk to them yourself.

[NorthBay]

It should be avoided at all costs, however, it is up to the anesthesia team wherever they can find the IV.

It's highly, highly unlikely that a deaf child's hand is the ONLY place they can find a patent IV site. Unless he's coding and there isn't a minute to spare, a deaf child (or adult, for that matter) should be given the opportunity to speak uninhibited. It may take a few minutes to find another location, but it's worth the time and energy to spare the child the trauma of not being able to communicate in the PACU. A vein-locating light (Vein Locating Solutions by Veinlite | Best Vein Finding Tools) is a fantastic investment for all pediatric patients, but is especially useful for a hospital that has a deaf patient as a frequent flier. All efforts should be made to ensure that hands are 100% functional.