Phlebotomy and kids

[NicInNC, CNA]

I had been going to school for Nursing, but decided to take a phlebotomy course this summer and LOVED it. I just got a job and will be working with infants to elderly. I stuck over 100 people during my clinicals, but we were never allowed to come in contact with children (except for watching heel sticks on newborns). I stressed my concern during my interview about how I had never stuck a child and they said they will be there to train me.

I need tips on calming a child (we learned the book way, but real life way isn't always the same) and I thought about buying a bunch of stickers or something to keep in my pocket to give them. I'm sure the lab will have some though. Just wanting tips/advice. I posted here because I figured that those thinking about working in pediatrics would benefit from the advice also.

Thanks!

[TazziRN, RN]

Not much you can do to calm them beforehand because they know what's coming. The best thing you can do is let them know it will only hurt for a minute or two. Stickers would be good for after, all kids like stickers. If you can get some that say something about being good and getting blood drawn (no matter how loud they screamed!) that would be great.

Whatever you do, do NOT lie to them. Don't tell them to look away without telling them what's about to happen, because they lose their trust that way. Don't let their parents lie to them. I will never forget holding a kid down to have his leg numbed up for suturing who was crying at the top of his lungs, and his mom said "Why are you crying, they're not doing anything!!" Doc and I looked at each other in total shock, and I said "Yes, we are, this hurts!"

[vamedic4, EMT-P]

1. Let them see their parents/ let the parents be involved if possible (to help hold, comfort). Kids get VERY upset when they can't see their mom or dad.

2. Have someone to help you with small children and infants, whether it be a parent or a nurse. The kiddos can get very unruly and sometimes 6 hands are absolutely necessary.

3. Stickers help, and diversion works for others. Some kids like to be talked to, especially the older ones.

4. Kids don't like being held down, no one does. With the small children, you may find that they cry because they're being held down and squeezed...rather than crying from the pain.

We use a solution of sugar and water to help calm infants, see if anything like that is available at your facility, and the possibility of using it during labwork.

Swaddle infants, leave out only the extremity you're going to stick. If it's a heel, leave only the one out you're sticking. This way the baby can't squirm and it keeps them warm in the process. Also helps you to keep them immobile.

I'll think of more as soon as my brain works again.

vamedic4

[Lfransis]

For me, it helps to gain confidence in the parents as well as the child. If the parent senses your discomfort, the child can cue from that. As vamedic4 said "let the parents be involved if possible".

- Always explain to the child what you are going to do and that yes, it will hurt a little and then it's over.

- Have your equipment set-up and ready, befor the child is seated, if possible. They tend to get nervous watching you pull out needles, tubes, etc. This can look even more invasive to him/her.

-Befor I uncap I always ask the child to look at the parent. I think the kids invision the WHOLE needle going STRAIGHT into their body.

Oh, don't put the tourniquet on too tight, their veins are usualy pretty healthy and easily palpated.

Hope any of this helped.

-lelu

[MIA-RN1, RN]

when you do a heel stick on a baby, warm the foot first. I put a warm washcloth inside a disposable diaper and wrap it on the baby's foot for a few minutes.

Put posters on the walls and ceilings for the kids to look at.