Physical restraint on uncooperative children

Nurses General Nursing

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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?

Specializes in Pediatrics.

Little ones are incredibily strong. Fight or Flight is a natural reaction.

A couple of weeks ago we had to do a LP on a 14 day old, it took me and the nurse to hold her in the correct position while the MD did the procedure, as soon as she felt the needle with the lidocane it was awful, she fought us as much as a 14 day old could and she was strong!

I have been there to help hold many a toddler who has needed stiches and it always takes at least 3 if not more to safely hold the child in the correct position.

My own son, last year to get his flu shot he was 8 at the time it took 5 people plus myself and a different nurse to give him his shot.

He thrawshed around so much he ended up with scratches on his arm from where the needle scraped him before actually going in.

Specializes in LTC, Hospice, Case Management.
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.

This has always been my solution too. Daughter had to have pre op blood work prior to getting tonsils out at the age of 4. I carefully explained what was going to happen prior to going to the Dr & assured her it would only take a few minutes & pain would be gone. I even let her pinch my arm as a demonstration of the pain being bearable and quick.

Went to lab, she held out her arm and allowed them to begin the process like a real trooper, didn't even flinch when they put the needle in. Without warning her whole expression changed & she looked up to me in panic with tears in her voice.."Mom, how are they gonna get that hole plugged so I don't bleed to death". :lol2: (oops, forgot to explain that part)

Guess I have been very lucky, neither one of my kids have ever given anyone any trouble with shots, blood draws or IV starts no matter what their age.

I kinda experienced it...but from the patient side. I was sick and had to get an IV in due to dehydration. I was about 7/8 and I know I fought the nurses, no one was gonna stick me with that huge needle. They had to hold me down too - 3 people in the end I think.

But then I had a phobia of nurses and doctors and needles after a doctor cut my hand open with scissors without anasthetic trying to get stitches out.

As a nurse and parent, I would never allow a physical restraint of my child. If my child requires a restraint--chemical restraint is more humane and less abusive to the child. The descriptions noted here are forms of child abuse. A child has the right to refuse a medication. A child has the right to pain and anxiety management---just as adults do. This thread frightens and angers me as both a healthcare provider and parent!! I would never let any of you "provide care" for my child.

Specializes in Emergency & Trauma/Adult ICU.
As a nurse and parent, I would never allow a physical restraint of my child. If my child requires a restraint--chemical restraint is more humane and less abusive to the child. The descriptions noted here are forms of child abuse. A child has the right to refuse a medication. A child has the right to pain and anxiety management---just as adults do. This thread frightens and angers me as both a healthcare provider and parent!! I would never let any of you "provide care" for my child.

No, a young child cannot dictate his/her treatment, e.g., refuse a medication. No, there has been no abuse described in this thread. And if you prefer a chemical restraint -- how do you propose it be administered?

OP, your posts clearly indicate you have never been in the presence of a small, frightened child who must unfortunately undergo some temporarily unpleasant treatment. That's OK ... it's outside of your life experience up until this point. Just consider some of the responses you have received here, from professionals who do this day in and day out ... and consider that you can't really have knowledge of things you haven't yet experienced.

There should be 3 adults holding a small child -- it's the only way to limit movement of all major joints so that necessary procedures can be safely performed.

No, a young child cannot dictate his/her treatment, e.g., refuse a medication. No, there has been no abuse described in this thread. And if you prefer a chemical restraint -- how do you propose it be administered?

OP, your posts clearly indicate you have never been in the presence of a small, frightened child who must unfortunately undergo some temporarily unpleasant treatment. That's OK ... it's outside of your life experience up until this point. Just consider some of the responses you have received here, from professionals who do this day in and day out ... and consider that you can't really have knowledge of things you haven't yet experienced.

There should be 3 adults holding a small child -- it's the only way to limit movement of all major joints so that necessary procedures can be safely performed.

Oral, benzos...and yes, there has been abuse. I am happy to see you in court about it. ;-)

Oral, benzos...and yes, there has been abuse. I am happy to see you in court about it. ;-)

I am having this discussion with my ped today. :-)

No, a young child cannot dictate his/her treatment, e.g., refuse a medication. No, there has been no abuse described in this thread. And if you prefer a chemical restraint -- how do you propose it be administered?

OP, your posts clearly indicate you have never been in the presence of a small, frightened child who must unfortunately undergo some temporarily unpleasant treatment. That's OK ... it's outside of your life experience up until this point. Just consider some of the responses you have received here, from professionals who do this day in and day out ... and consider that you can't really have knowledge of things you haven't yet experienced.

There should be 3 adults holding a small child -- it's the only way to limit movement of all major joints so that necessary procedures can be safely performed.

I am a healthcare professional. I have a young child--and I am getting benzos for him. He is due for his 6 months shots. I require lidocaine for my own IVs--I am not subjecting him to "just suck it up and deal with it" I dont believe in "toughing it out".

Specializes in Trauma, Teaching.

WTH? Benzos for a 6 month old for shots? :eek:

If your Pediatrician agrees he's off his rocker.

WTH? Benzos for a 6 month old for shots? :eek:

If your Pediatrician agrees he's off his rocker.

Why? What is the difference between a painful outpatient procedure and a painful inpatient procedure? He had 10/10 pain with the last set and screamed for 15 minutes straight. No need to subject him to that. One time dose prior to procedure.

Specializes in ER.

I agree that it can sometimes take 3-4+ people to safely hold a child for an IV stick. BUT if you need that many every time, and for every child, it may be that some gentle prep work with the kids will help. Kids over 3 can understand to some extent that we are trying to help them, and we want to make them better. My most effective approach has been to let them look at and touch the equipment, while I explain how I need them to help me by being still. They can scream as loud as they like though. If I'm pretty confident I get kids to start counting, and by the time they get to 10, or 20 we will be done.

Specializes in PICU.
As a nurse and parent, I would never allow a physical restraint of my child. If my child requires a restraint--chemical restraint is more humane and less abusive to the child. The descriptions noted here are forms of child abuse. A child has the right to refuse a medication. A child has the right to pain and anxiety management---just as adults do. This thread frightens and angers me as both a healthcare provider and parent!! I would never let any of you "provide care" for my child.

Wowza. No one here is trying to hurt a child. And I've never expected or asked for a child to "suck it up" or "get over it" when I need to provide treatment that could be scary and/or painful. Believe it or not I don't like to see kids hurt and I didn't get into this field or department to "torture" kids. Where I work we have a strong focus on pain treatment and prevention. We have a pain team that is dedicated to the education of and enforcement of these topics. Even if I use lidocaine on a child (which we do for every single stick), do you really think that a 2 year old will hold still? They are scared and that is understandable. You would rather I use continuous sedation (a drip) on an alert child with an EVD (which will stay in place for several days), rather than put an arm board on their arm so they don't try to pull it out? Sedation can have many side effects (and we don't do it unless we have to) but, according to you, that arm board is abuse! How dare we??? What about an armboard on an IV? That is a restraint? I should let the kid just keep picking at or pulling at an IV and risk having to keep restarting a new one? We have child life and every kind of form of comfort we can provide. But I don't need to justify to you. This reminds me too much of people that come to the hospital for care but then refuse the treatment options. Why seek care? Are you saying you've never had a scared patient or you've never had to hold their hand or arm while putting in an IV? Isn't that considered a restraint? What do you do in nursing?

Let's just say I will be HAPPY to not care for your self-righteous attitude. I love caring for my pediatric patients. It's usually the parents that are a problem. Maybe have a little faith in your fellow healthcare workers. And I hope you never get the first hand experience of having your child need some serious healthcare and you are begging for help. Get over yourself.

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