Uncooperative Kids

[Minnesota123]

How do y'all handle difficult behaviors? I work in a ped ER and it's so hard to get some of the kids to cooperate. They'll often just sit there and pretend that I don't exist. It's so hard to get medical procedures done. How do you get IVs in, meds given, shots injected?

[LessValuableNinja]

Depends on the age.

There was much therapeutic holding (restraint) when I was in peds. If it's less urgent, emla works decent, but there are a variety of sprays that are faster.

If there's a protocol or order, a temporary restraint (arm board) can help getting the IV in, sine that makes it easier for nurse 2 / tech / parent to snuggle therapeutically.

If you have time, certain ages of children are more prone to bribery than others. Some places have the white / clear popsicles without dye that work well when negotiating agreement terms with the littleun.

Shots are a lot easier than IVs, since they're Uber fast.

For older kids, I usually found treating them more like an adult and explaining the process and reasoning beyond it helps. For younger kids, I've seen a lot of simple explanations, therapy snugs, bribery, and puppets.

Also, television. Or parents iPhone. Or whatever. Be a ninja and sneak it in when they are mesmerized with Twilly dilly and pilly, or whatever their favorite show is.

[KelRN215, BSN, RN]

Ask the parents what works best for their child. If it's a child with chronic illness, the parent may give them medication every day.