Who numbs for needlesticks?

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I am finding research about the pain of needlesticks and that it is good for patients long term if we don't subject children to the pain of needles. In addition to EMLA, there is LMX4 that is quicker (30 minutes), buffered lidocaine that can be injected with a 30 gauge needle almost painlessly or with a J tip and works in 1-3 minutes. According to some of the research I see, cold spray is helpful for IM injections, but not as much for pain associated with an IV start. There are mixed results about cold spray for IV starts. In addition there are other more expensive ways to decrease pain of needlesticks. These are probably the cheapest.

Who out there is using medicine or other devices to prevent pain of needlesticks in children? What do you use? Do you have a policy in place about it and how well are the employees able to follow it?

where i am a patient. if you are on the floor and they need to put a new one in they do not use it, told they dont have time to use it on every single patient who needs a new one.

i have also had ivs in radiology and proop and if you request it they use it. it may be more rutiene on younger kids but at my age if you ask they will

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I've been wondering why we think it's not acceptable to allow children to go through this kind of pain but it is fine to allow adults to go through the same pain? Where else do we provide pain relief only based on age?

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Specializes in LPN, Peds, Public Health.

Personally, I think numbing the area before an injection is more of a "mental" thing for kids. It seems to me that the needle stick itself isnt what hurts, its the actual medicine going in and burning. I watch it on their faces everyday, they are fine until I push that medicine in. But Im just speaking toward giving injections, not IVs and ports and all that. I say, if it helps the kid to relax then rub some on there. As for the little ones I really dont see the use of it since the external numbing isnt going to help the burning. Just my thoughts on it.

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In our office we use a "shot blocker". It is this little yellow flexible plastic thing that has little "poky" things on one side that distract and kinda even the pain when we do injections. It seems to help even if it is just a mental thing for the kids.

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Specializes in LPN, Peds, Public Health.

I have never heard of such a thing. I will have to check it out.

Personally I would just prefer to get it done and over with though. And, if I might add, Im pretty good so my kiddos dont cry for long :)~

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I've been wondering why we think it's not acceptable to allow children to go through this kind of pain but it is fine to allow adults to go through the same pain? Where else do we provide pain relief only based on age?

I may get flamed for this but...

Really? Its just a needle stick! If it were up to me, there would be a lot more "suck it up"s being passed out. Sure, having a needle stuck into your arm for IV, blood draw or IM hurts....for about 5 seconds. The potential bruising etc is still going to be there after the emla wears off anyway.

As for kids...I'm pretty much of the same mind. Its going to hurt for a second then it will go away. Its not that big of a deal. The kids aren't going to be traumatized by a blood draw, they get worse at home when they stub their toes. Frankly, the "We're going to put this magic cream on you so the NEEDLE won't hurt...we'll be back in 30 minutes" will probably cause more anticipatory pain and suffering then the actual needle itself.

I'm all for pain control but I don't consider the pain from a needle stick worthy of pharmaceutical prophylaxis.

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I may get flamed for this but...

Really? Its just a needle stick! If it were up to me, there would be a lot more "suck it up"s being passed out. Sure, having a needle stuck into your arm for IV, blood draw or IM hurts....for about 5 seconds. The potential bruising etc is still going to be there after the emla wears off anyway.

As for kids...I'm pretty much of the same mind. Its going to hurt for a second then it will go away. Its not that big of a deal. The kids aren't going to be traumatized by a blood draw, they get worse at home when they stub their toes. Frankly, the "We're going to put this magic cream on you so the NEEDLE won't hurt...we'll be back in 30 minutes" will probably cause more anticipatory pain and suffering then the actual needle itself.

I'm all for pain control but I don't consider the pain from a needle stick worthy of pharmaceutical prophylaxis.

I must respectfully disagree. To this day (16 years later) I still remember one certian blood draw.Blood drawa, yes most of the time they will not tramatize a child. I had MANY MANY in my life and remember very few of them, about 5 in all, 1 VERY VIVIDALLY because the person doing it screwed up REALLY badly. It was a med student and she tried 3 times and was fishing around ON A 5 YEAR OLD. It was the first time she had done it she told my parents. After 3 times they demeanded she stop and get a nurse who had been doing it for 20 years come in and that lady got it first try. But the first doc I still remember it VERY VIVIDALLY to this day

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I was talking more of IV starts than injections. I have had a dozen surgeries myself, and I have worked extremely hard to overcome my fear of needles that resulted from the IV starts I had as a teenager in the hospital. I remember spending almost 2 hours in the treatment room while nurses fished around in my hands with a needle.

I've been in places where it was routine to use numbing agents on ALL IV starts, adults or children. I've had it done both ways, and I believe that numbing agents make a big difference. Call me a pansy if you want, but at this point, I would insist that the doctor write an order for a numbing agent to be used if I or my kids had to have an IV placed.

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Specializes in Telemetry & Obs.
I may get flamed for this but...

Really? Its just a needle stick! If it were up to me, there would be a lot more "suck it up"s being passed out. Sure, having a needle stuck into your arm for IV, blood draw or IM hurts....for about 5 seconds. The potential bruising etc is still going to be there after the emla wears off anyway.

I'm all for pain control but I don't consider the pain from a needle stick worthy of pharmaceutical prophylaxis.

Obviously you have good veins. I don't. For a recent follow-up breast MRI I was stuck three times for an IV...three if you just count the needle actually entering the skin. Not sure how to count the *riggin digging around because "something HAS to be around here somewhere!". It took two people over 30 minutes to finally get an IV in for the contrast. Sure, I "sucked it up", but would have appreciated a little something for what was much longer than "5 seconds" of pain.

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Specializes in LPN, Peds, Public Health.

I have had many IVs in my years, I also have horrible veins.

I was in the hospital for 2 weeks after my daughter was born. IVs the entire time, and of course, they would have to be changed quite often. There was one night that I had 2 nurses on my left arm and a nurse on my right arm ALL digging in my arm trying to get on IV. Sure it hurt, sure it bothered me and I was upset, but it didnt traumatize me. Its just something that sometimes happen.

I dont really care if they use the numbing medicine on me or not. Actually, it burns more than getting the IV done.

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Specializes in PICU/NICU.
I may get flamed for this but...

Really? Its just a needle stick! If it were up to me, there would be a lot more "suck it up"s being passed out. Sure, having a needle stuck into your arm for IV, blood draw or IM hurts....for about 5 seconds. The potential bruising etc is still going to be there after the emla wears off anyway.

As for kids...I'm pretty much of the same mind. Its going to hurt for a second then it will go away. Its not that big of a deal. The kids aren't going to be traumatized by a blood draw, they get worse at home when they stub their toes. Frankly, the "We're going to put this magic cream on you so the NEEDLE won't hurt...we'll be back in 30 minutes" will probably cause more anticipatory pain and suffering then the actual needle itself.

I'm all for pain control but I don't consider the pain from a needle stick worthy of pharmaceutical prophylaxis.

I'm gonna have to disagree with you on this one. Wasn't too many years ago that we didn't use local for a circumcision because the baby wouldn't remember it anyway.

It absolutely IS "that big of a deal" to have an IV start- kids veins are not like ours and sometimes we have to stick them more than once to get a IV started on a dehydrated chubby little toddler(Even us IV experts). While I agree, it is probably just as scary to be wrapped up and basically held down for the start- I feel that it is absolutely important to be numb while we are digging around for a tiny little vein.

We are using the J-tip.... I really like it. We have seen great results so far! We also tried it on each other and I can honestly tell you that I felt NOTHING when my IV was started. Sooooo much better than EMLA or that freeze spray!

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I'm gonna have to disagree with you on this one. Wasn't too many years ago that we didn't use local for a circumcision because the baby wouldn't remember it anyway.

There is a pretty big difference between having a needle stuck in your arm and having your foreskin cut off.

Just sayin

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