Who numbs for needlesticks?

Specialties Pediatric

Published

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?

Add me to the pansy list lol, I think in some cases it is a good idea (if it looks like you are going to have to dig around) and sometimes there is no point (Huge hose for veins people)

I like to be numbed but these days I have stopped asknig. I was enver given any issue about it (since my hospital is a peds hospital so they are used to it) but I felt like a baby. I warn the nurse I am needle phobic but am able to deal with it. I then start doing deep breathing while they start getting ready to do it and just keep breathing right through it, and usually do pretty good. Only time recently I freaked was a nurse who was not terribally good at ivs was trying on me. could not get the cathater into the vein, the cathater actually bent, and she was digging. she pulled out and my actual nurse did it. and got it.

Perhaps the person saying "suck it up" has never been in the hospital with their own child. I have-- watching my 4 year old son tear up each time someone walked in the room b/c he knew he would get stuck again was painful. He tried so hard to be a brave boy and didn't fight at all, but it would have been tons better on him if we could have numbed the site. For kids who don't trust nurses and doctors anyway, it is a great idea. It shows them that we are doing our best to make it as painless as possible.

Specializes in paediatric and trauma.
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.

I have horrible veins the hospital dont like mine and when trying to find a vein to put in the IV its like trying to get blood out of a stone i have had 15 Ivs in my life so far from being about 7

Specializes in Pediatrics, home care.

We can get the LMX on override if we want it and the J-tip by order. However, I agree with the vasoconstiction comments. For infant to 5y the holding down seems to be the worst part and that can't be fixed. We just use distraction and emotional supprort of course, plus the child life specialist during the day.

You guys have to get local creams ordered in the US? (I'm guessing that means prescribed!?) We use ametop or emla on most kids for IV insertion and it doesn't need to be prescribed. We can just decide to give it as nurses with no doctor input.

As a Pediatric ER Nurse and a Pain Resource Nurse I would encourage you to check the literature. There is substantial research which indicates that pain control for needle sticks (even for IMs) can have a positive effect on the overall outcome for the patient. Conversely, failing to treat pain can affect the patient's physiologic response (not just psychological) to that procedure AND future procedures.

We use Jtips (needleless delivery of buffered lidocaine), cold spray for injections and IV starts and EMLA for LPs and port access.

Incidentally, for those of you who are having little success or patient discomfort with cold spray, you may consider the "snowball" method. Saturate a cotton ball with the cold spray and hold it in place with pressure for 15 seconds immediately before needle stick.

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