Toddler/Preschool Immunization techniques

[Squeaky44]

Hi! I am new to peds office nursing and desperately need some tips on administering vaccines to toddler/preschool children. Where I am working at, we administer the vaccine in the thigh. How do you position/restrain the child? Also, what ideas for distraction techniques do you have? Any information would be helpful. Thanks

[elprup, BSN, RN]

Get parents to hold child in their lap. Childs legs between their legs and make sure they have their arms held. If kid is really squirmy or really scared, I would have dad hold kid on his hip (just like normal) while dad was standing up, and I would quicking grab leg from behind/side of dad, so child could not see me, and inject in the thigh. This seemed to help with an autistic child.

Obviously you have to clean it first. You have to be fast. Sometimes I would have 5 immunz to give and it was a matter of making sure the parent understood that they had to hold them tight, because if I missed or do not get entire med injected, we would have to do it again. I would line up all my immunz and bandaids and just do it. In the beginning, try to have somebody/anybody go in with you to help hold the kid and guide you until you get experience.

Oh and when you walk into the room do NOT let the kids see the shots and do not talk about shots. Do not let kids see shots at all. I would have parent hold kid and I would have my shots to the side. Have them all ready and labeled before you go in. When you go in grab alcohol wipes and bandaids while you remind parents that you will need their cooperation and how to hold child. And how important it is that they really hold them tight. Then just do it.

Make sure kid has his pants off to access sites before you go in as well. Usually they are already undressed because they just had a well child visit. Obviously, it is not always going to go smoothly. One kid kicked me and I dropped the immun. parent learned real quick to hold them tighter, and I learned to make sure they did !! Also, it gets real fun when the parent says I am going to have the nurse give you a shot because you have been bad. Poor kids!

Hope that helps.

[KelRN215, BSN, RN]

Sit kid in parents lap. Have parent give kid a bear hug and wrap their legs around kid's legs.

[dansamy]

Sit kid in parents lap. Have parent give kid a bear hug and wrap their legs around kid's legs.

This.

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[Squeaky44]

Thank you all so much for your advice! It is much appreciated :)