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???
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.
This makes me so sad. I don't work with children, to hear about one being traumatized like that rips my heart. I've only taken care of one deaf person and never had to think of this issue because we didn't use restraints. I'll be aware to never put an IV in a deaf person's hand, I'd just never really had thought about it d/t not taking care of many deaf patient's. Thank you for sharing this so we can all be more aware in these instances. I feel so sorry for the child and family. If it were my kid I'd be fighting mad.
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.
If he's had close to 50 surgeries, he may be a difficult stick by now. It sounds like he is quite ill. Perhaps a mediport? Although I'm sure in most situations just 1 line wouldn't be enough.
Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
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.
Since he's had 50 surgeries and no implanted port, I bet his veins are NOT the easiest to find.....I could be wrong, however, again...unless you're there, it's difficult to see/say what is occurring.
Again, the priority is not the end...it should be because you're frustrated and reasonably so...but unless you're the anesthesia provider responsible for this child, you have no say.
For the past 2 years, all of my clients surgeries have not been "rush to the OR" type surgeries. They have been scheduled surgeries. The veins in his arms are not compromised and could be used as well as many other sites on other parts of him. And I disagree with "you have no say as to where they place an IV". Your body is your body and if you dont want an IV in a certain site, you have the right to refuse. Unfortunately my client is only 5 and doesnt know this. Mom does but again it gets lost in translation some where along the line
I have only been with him for almost 2 years now, and only for a handful of surgeries. Most of his surgeries were around the 6 month of age mark. It is on his chart that he is deaf, it is written on the pre-op paperwork and it is given verbally to the staff. Besides writing on the kid's hands, there isnt much else to do. I am homecare in one district, and the hospital is in another city. I write notes, but again, no one is listening.
For the past 2 years, all of my clients surgeries have not been "rush to the OR" type surgeries. They have been scheduled surgeries. The veins in his arms are not compromised and could be used as well as many other sites on other parts of him. And I disagree with "you have no say as to where they place an IV". Your body is your body and if you dont want an IV in a certain site, you have the right to refuse. Unfortunately my client is only 5 and doesnt know this. Mom does but again it gets lost in translation some where along the line
Absolutely! When I was in labor, a nurse tried to put an IV on the side of my wrist. She was informed in no uncertain terms that would NOT be happening.
Have to agree with JoPACURN. Whether it's a rush surgery or not, if that's the best vein he's got, it's the best vein.
Can I refuse an IV in a place I don't want it? Yup, I can. But I have to face the consequences, which could possibly mean not having whatever procedure I'm scheduled for due to lack of access.
Kids do NOT have lots and lots of choices for access. Even with a light. Especially chronic kids.
Peds anesthesiologists don't come into the room and say, "What's the absolute WORST vein I can choose on this kid? Mwuhahaha! I'll put it in his hand since he's deaf! I absolutely HATE children! Mwuhahaha!"
Yes, it sucks for him. Waking up from surgery sucks for most kids. They wake up in a strange place and they're confused. I imagine it's extra confusing not being able to communicate. But I'd rather there be good access during surgery and wake up from it, rather than safeguard their hands and the kid not wake up.
Have to agree with JoPACURN. Whether it's a rush surgery or not, if that's the best vein he's got, it's the best vein.
Can I refuse an IV in a place I don't want it? Yup, I can. But I have to face the consequences, which could possibly mean not having whatever procedure I'm scheduled for due to lack of access.
Kids do NOT have lots and lots of choices for access. Even with a light. Especially chronic kids.
Peds anesthesiologists don't come into the room and say, "What's the absolute WORST vein I can choose on this kid? Mwuhahaha! I'll put it in his hand since he's deaf! I absolutely HATE children! Mwuhahaha!"
Yes, it sucks for him. Waking up from surgery sucks for most kids. They wake up in a strange place and they're confused. I imagine it's extra confusing not being able to communicate. But I'd rather there be good access during surgery and wake up from it, rather than safeguard their hands and the kid not wake up.
I dont think in all of my posts that I wrote that they put in his IV in his hands because they wanted to be mean. I know it is a very logical place, but, the kid uses his hands to talk. He is fluent in sign language, can sign over 1200 words. There are other places on kids to place IV's other than hands. ESPECIALLY a deaf child. It is written in his chart that he is deaf. Also, not once have they refused a surgery because they were told not to put an IV in his hands.
This would make any parent really angry and sad also. It made me mad also when i read it, very. Children are so vulnerable and traumatic events can really screw up a child, no doubt about that!
The mother should of asked and drilled them to make sure it didn't happen again.
I think from a nurse's perspective it's different, the job needs to get done, he needs to get sedated and surgery needs to happen.
From a mother's perspective this is her child-nurse's place yourself in her shoes.
I think this could of most definately been prevented, but really if his hands were the only place to put the IV then there's no other way, it stinks.
I dont think in all of my posts that I wrote that they put in his IV in his hands because they wanted to be mean.
No, but you assume that they just don't care. Consider it from their point of view. They need good access. And a 5 year old with 50 surgeries is NOT going to have a lot of good veins. Their biggest priority is making sure the kid makes it through surgery. As it should be.
I've watched IV goddesses have to stick somewhere they'd rather not stick, just because it's the only good spot. Using toddlers' feet, AC in a kid who has a cast on their other arm, the hand that has the thumb they suck. I'm not saying it's great for this kid, but I'm going to trust the person there at the time with responsibility for the patient at that time.
Coming through the surgery SAFELY is the #1 priority. Hierarchy of needs. Living comes before communicating.
Every once in a while instead of assuming that another healthcare professional doesn't know what they're doing or doesn't care, perhaps we should step aside and assume they have the best interests of the patient in mind. They just don't have the same opinion of what those best interests are.
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RaeRae1997
30 Posts
This makes me so sad. I don't work with children, to hear about one being traumatized like that rips my heart. I've only taken care of one deaf person and never had to think of this issue because we didn't use restraints. I'll be aware to never put an IV in a deaf person's hand, I'd just never really had thought about it d/t not taking care of many deaf patient's. Thank you for sharing this so we can all be more aware in these instances. I feel so sorry for the child and family. If it were my kid I'd be fighting mad.