Physical restraint on uncooperative children

[Aleccandra]

I am 18 and just started my apprenticeship to become a medical secretary working for a pediatrician.

The other day i was talking to my colleague when she told me about a 5 year old girl who had to get a neccessary injection which she refused because she has needle phobia and 3 people tried to hold her down but they still could not get it done because the girl was raging and was unable to restrain.

Now i am wondering how can it be that 3 adults are unable to overpower a 5 year old girl.

I told my collegue that its hard to belive and that i think if i was with them i would just hold her tight with my arms

wrapped around her body and somebody only has to take her arm and get the shot done.

But she (my collegue) said that she was also surprised by that girl's strength and never experienced something like that before. And shes working there for over 20 years.

But i still find it hard to beleive.

Did anybody ever experienced something like this?

[chloecatrn]

are you serious? 3 people for a 3 year old?

there is mo way i would let a 3 year old break free when i hold her/him tight.

i am 5.5 128lbs and not the strongest but a 3 year old...

I'm finding you a little judgmental. You don't seem to have much of an idea what it's like to fight with a little one who's scared out of her wits when she's about to get poked. Shots are one thing. Try holding a 3 year old down for an IV start. That's a whole 'nother can of worms.

[vlomankill]

i agree with chloecatrn. your judging and not listening.

[DogWmn]

LOL Family Practice and Peds clinics here, I send parents out of the room, and then I can usually manage with another nurse, the hold I use will depend upon the size of the kid. Where I give the shot will depend on what I'm giving.

[OCNRN63, RN]

are you serious? 3 people for a 3 year old?

there is mo way i would let a 3 year old break free when i hold her/him tight.

i am 5.5 128lbs and not the strongest but a 3 year old...

That's what you think. Having worked many years ago in peds and then in the ED, I can assure you that little kids can be absolute titans if they are afraid. A three year old could take you if he/she was scared enough.

[jrw03282009]

When my son was getting his 1st blood draw, it took the doctor, his three nurses, myself AND my husband to hold him still enough for ANOTHER nurse to draw on him. He was 4. He gets blood draws every 6 months now and is just as scared as the first time. The only difference is... he has gone to the same Dr since birth (he is now 9), we now schedule at 5pm, and everyone is a pro when it comes to knowing how to hold him and not hurt him. It never gets mentally easier tho...

I would like to know if the OP has ever had to hold a frightened child that is doing everything in his power to get away from the needle? ESP when they are trying to draw on said child, not just give a shot. I would rather have 5 adults hold a child safely than one big shot that ends up harming to prove a point.

[N2NRSING]

I have two kids who hate needles however I have worked really hard at explaining the process at home before we go to the doctor so they have a good idea of what's coming, I also firmly tell them there will be no negotiating as far as the shots and they will get them even if they fight it and it will be easier and less painful if they cooperate, I feel if parents really educated the kids it would be a bit easier or at least significantly reduce these type of cases? I wish more parents agreed.

[starmickey03, MSN, RN]

I've worked in a doctors office, you don't want the parents to hold the child, that is not their role, and yes children will kick in to the fight or flight mode, and become little incredible hulks.

The "incredible hulk" comment made me LOL...

But seriously OP, this is very true. Unfortunately, I have to help restrain my kids when they get their injections and it is HARD. Kids are extremely strong, just as any other person would be when they enter "fight or flight" mode. The last time my daughter got a shot she was about 15 months and it took 2 of us in addition to the nurse that actually did the injection to hold down my baby girl that only weighed 21 lbs at the time. And don't even get me started on my son when he was an infant/toddler, he brought a whole new meaning to super strength. It may be hard to believe if you've never been put in the situation but rest assured that no one here is exaggerating.

If you still don't believe, then maybe you need to google "fight or flight" and search for some of the things people have done when they've entered that mode. Lifting a car or even a boulder isn't shocking when someone is in "fight or flight" mode.

[ChristaRN]

Girl, come back after getting some Peds experience and tell us that then.... I guarentee you that your opinion will change.

These kids are POWERFUL!

are you serious? 3 people for a 3 year old?

there is mo way i would let a 3 year old break free when i hold her/him tight.

i am 5.5 128lbs and not the strongest but a 3 year old...

[WoosahRN, MSN, RN]

Oh yeah, easily. I work Peds (PICU specifically). Those little guys are crazy strong. Even on 1-2 year olds...if I need to stick a foot for blood or IV (non walkers), my hand cramps up from trying to hold their foot still. And that is with them wrapped (blanket) and another person holding them down. And you still don't get the blood you need because they are so freaked out they vasoconstrict. Ufda! Thank goodness for central lines!

[nursel56]

I have two kids who hate needles however I have worked really hard at explaining the process at home before we go to the doctor so they have a good idea of what's coming, I also firmly tell them there will be no negotiating as far as the shots and they will get them even if they fight it and it will be easier and less painful if they cooperate, I feel if parents really educated the kids it would be a bit easier or at least significantly reduce these type of cases? I wish more parents agreed.

I think most parents do agree, and they do try to explain things to their children. It's great that you are able to get your kids to cooperate, but it has nothing to do with how good an educator the parent is. It has to do with children's instincts to avoid pain and the fact that no one should expect them to reason through it the way an adult would. We many times would wait (within reason as we were busy) for parents to go through the long explanation process and the child will still need to be scraped off the ceiling.

In some cases the extra time spent by the parent explaining things actually had the opposite effect and made the child more anxious. You shouldn't spring it on the child or lie to the child or tell them the shot is a punishment of some sort (which thank God I never heard but others have) the best way to do it is get all your ducks in a row with helpers and do it as quickly as possible. Then heap all sorts of praise on the child and give them a sticker. :)

[WoosahRN, MSN, RN]

OP, in all seriousness, you should help hold next time if you are allowed. More for experience and so you can get an idea of what it is really like. Then you will be able to answer the question for yourself.

[dudette10, MSN, RN]

Aw, c'mon. You can restrain a kid with one person. Just do this!

This isn't to poke fun at the OP, but I don't think she's taking into account that the more aggressive restraint techniques aren't accepted practice in healthcare. :) Trying to avoid hurting a kid requires more than one person because the force and positions needed for one person to hold all limbs motionless would look and feel like something straight out of COPS.