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To think that four hours was too long

(89 Posts)
pamplem0usse Sat 09-Feb-13 23:49:24

My 4.5 mo DS needed a medical procedure on fri that required a cannula.
Four doctors attempted for two hours before calling an aneasthetist to have a go. He tried for another hour and a half and failed. There are at least fourteen puncture wounds in his neck alone, each representing several attempts.
I eventually called a halt to it as he'd not been allowed milk for five hours and the procedure would have taken another hour. He wasn't given any form of aneasthetic. They want me to go in for another try next week. would i be being unreasonable to insist we have it done elsewhere?

lisad123everybodydancenow Sat 09-Feb-13 23:52:22

Message withdrawn at poster's request.

pamplem0usse Sat 09-Feb-13 23:54:50

Yes they were. And it wasn't an emergency procedure. I felt bullied into letting them carry on :-( it was them against my son's chubby limbs

WorraLiberty Sat 09-Feb-13 23:54:54

Oh my dear God that's awful shock

YANBU, your poor baby sad

AgentZigzag Sat 09-Feb-13 23:55:55

Oh my goodness, the poor little mite.

And you having to watch that play out <hug>

I don't know anything about how 'normal' it would be for that to take so long, but just from being a parent myself, I would say of course you're not being unreasonable to want somewhere else to do it.

They've hardly inspired any trust, things may not work smoothly all the time, but when it's a baby (?) involved, other things you might think of outside the situation don't count.

How is he now?

How are you doing?

McNewPants2013 Sat 09-Feb-13 23:56:00

sad poor baby did they give you a reason why putting a cannula was difficult.

pookamoo Sat 09-Feb-13 23:56:59

I'm afraid I might be thinking about putting in a complaint, or at least asking for a meeting to discuss this, OP. Sounds horrible for you, and him, poor baby. sad

AgentZigzag Sat 09-Feb-13 23:57:35

'it was them against my son's chubby limbs'

That is just such a sad thing to write.

Bearbehind Sat 09-Feb-13 23:57:53

I have no experience of this but yanbu, your poor little boy, that's shocking

steppemum Sat 09-Feb-13 23:59:40

when dd2 was 18 months old she was in and out of hospital for about 1 year. One time she was in for 1 week and required canulas and blood tests etc.

The staff were amazing and would not have dreamed of carriying on for so long. One time when they struggled they stopped and postponed for a while and then tried a different approach. They had experienced well trained staff, but it did often take more than one go.

4 hours is too long, and too distressing.

pamplem0usse Sun 10-Feb-13 00:00:29

He's very chubby and his circulatory system.is poorly developed. And the junior docs collapsed all the 'good' veins. He's doing ok I think :-s. Me, less so. The nice guidelines say noone should attempt more than twice vefore getting someone more senior apparently.

HugAndRoll Sun 10-Feb-13 00:01:20

It took 17 attempts to put in one Canula in my 9 month old ds2 on Monday. Babies are terribly difficult to get visible veins from. My sons was an emergency though as he was horrendously dehydrated and at that point they also thought he had meningitis (was just very severe rotavirus) and he was only discharged yesterday. They said it was his "good covering" that made it so hard.

TheSecondComing Sun 10-Feb-13 00:06:32

Message withdrawn at poster's request.

pamplem0usse Sun 10-Feb-13 00:09:17

the anaesthetist said he's too little. He was v cross because DS's crying was making his neck a 'moving target'. and apparently he'd nevrr failed with w chubby baby before :-(

rubyjuice Sun 10-Feb-13 00:09:21

Was there a nurse present? It should have been their job to act as the patient's advocate and stopped the Dr's.

pamplem0usse Sun 10-Feb-13 00:10:06

three nurses holding him down.

MrsMushroom Sun 10-Feb-13 00:12:11

Oh how awful! Oh I feel terrible for him and you too! I hope he is better soon. xx

MorganLeFey Sun 10-Feb-13 00:13:12

If it wasn't an emergency procedure then I think I would've called a halt before then.

Not sure that going somewhere else will definitely mean automatic instant success though - the number of doctors who tried & then getting an anaesthetist suggests that it was difficult... & sometimes it just is & isn't exactly fun for doctors involved earlier. sad

Being aware of the previous problems may mean that they can escalate to a 'Plan B' straight away next time with one of the more experienced doctors having the pick of fresh veins/distraction/?sedation if appropriate etc.

BarredfromhavingStella Sun 10-Feb-13 00:28:35

This sounds horrendous, your poor child sad

Complaint is most definitely in order, sound like a bunch of moronic egos to me, just disgusting.

Rootvegetables Sun 10-Feb-13 00:34:54

That sounds awful. You are well within your rights to go elsewhere but maybe you should ask for a plan before you go into hospital so they get their best person to try straight away also ask for some numbing cream prior to the procedure and think what you can cope with for example 2o mins then we stop. All of these are reasonable requests and frankly for a non emergency proceedure your previous experience was not on. Something you can do to help is get him really toasty and warm before they start as that can help. Poor all if you, one of the nurses should if said stop.

OMG that poor poor baby UnMN {{{hugs}}} to you and your sweet baby. sad My first baby had to have blood drawn daily from about 4 days old, the doc used to position him just right and had the blood from his neck super fast, my poor baby didn't seem to even notice. I still couldn't watch.
I's pick a different place to get the cannula inserted, is there a childrens hospital anywhere in driving distance, they deal with little ones and poor veins all the time, you need the experts.

HollyBerryBush Sun 10-Feb-13 06:30:17

What would have happened had it been an emergency?

FellatioNels0n Sun 10-Feb-13 06:33:26

Good grief! What, no numbing gel or anything? shock Poor child. sad He must have been very distressed.

HollyBerryBush Sun 10-Feb-13 06:37:31

Do you mind me asking, what the procedure was, if not an emergency on a 4 month old?

Sokmonsta Sun 10-Feb-13 06:42:49

Gosh that's awful for you and Ds. I would complain. You thought you were doing the best thing by letting them continue. In the future don't be afraid to stop them sooner.

My experience first came when Ds was 7 weeks old, and again at a year. I quickly learnt that one consultant was no good with trying to draw blood, let alone change a cannula and asked for a specific nurse to come and do it.

Some staff just aren't good with the teeny ones. And while it isn't an excuse for doing what they did to your Ds, 14 attempts for a non-emergency, along with comments about not failing before smacks of trying to prove they won't be beaten by a baby.

myBOYSareBONKERS Sun 10-Feb-13 06:43:35

If it was an emergency eg - the baby had arrested - there are other methods that can be used in those situations.

Booboostoo Sun 10-Feb-13 06:43:59

I am so shocked at your post! DD had a cannula inserted at 16 months by the paeds nurses and they knew it was going to be difficult (A&E nurse had tried and failed to take blood the day before). The nurse tried twice and called the more senior nurse immediately who got it done fairly quickly. The whole thing took half an hour and DD had to be held down (no other option) but the nurses were very understanding, talking to her in a soothing voice, trying toys, etc. and I was there trying (and failing unfortunately) to keep her calm.

I thought the whole experience was a horrible nightmare so I can't even imagine what it must have been like for your DS and you! Do complain and see if you can get them to plan ahead next time. The length of time they took is totally unacceptable!

pamplem0usse Sun 10-Feb-13 06:47:11

he needed a scan of a part of his digestive system as hes had chronic diarreah for ten weeks and blood in his stools.
We asked about time limits next time and they just said it was down to the individual doctors tolerance (i.e. no mention of ny baby) :-(

Isityouorme Sun 10-Feb-13 07:09:34

It is for reasons like this that I would never let a junior doctor touch my child. Poor thing, and you. Sadly I have been there too, but not anywhere near as bad, and it is heartbreaking to do.

Next time ask for a senior doctor first.

flow4 Sun 10-Feb-13 07:24:18

Oh pamp, that sounds totally appalling - as if they forgot he was human, not an object or 'challenge'. :-(

That would have been too much for an adult, let alone a child. But an adult would have stopped it much, much, much sooner. My veins are hard to find, and when I was a young teen, a junior doc once had 4 attempts before a nurse stopped him. Now I'm an adult, anyone taking blood gets ONE go, maybe two if they're especially nice - then if they don't succeed, I ask for someone else.

I would definitely go elsewhere, if you can. Insist they stick to 'two tries' rule. And ask for him to be sedated if they don't succeed immediately.

I had to pin down & repeatedly kiss my sobbing 8 week old whilst they butchered tried to put a cannula in him. I stopped them after 8 attempts. H was screaming at me & looking at me that way.

I was so cross, I was only there with him because --fucking stupid--HV had bullied gp into referring us for prolonged jaundice.

All other tests showed no worry, very slight jaundice, only visible in whites of eyes. They wanted me to bring him back for another go 2 weeks later & I refused. Was lectured by paed nurse, who I reported, spoke to paed consultant who said he wouldn't want cannula in anyway.

I made a complaint. DS is now 10 months old & I've heard nothing despite chasing it twice.

Speak to someone to make absolutely sure that the procedure is necessary.

I hope he's on.

InTheNightGarden Sun 10-Feb-13 07:27:55

I had an experience just like this!!! My dd has duplex kidney and required a full day of different tests at bristols children's hosp (she was 5 months)

For one of the scans she needed radioactive fluid in her blood stream, they attempted god knows how many times in her hands and feets, and to start with without me knowing it was student trying to do it!! They only stopped when I burst into tears! We went back the following week where I was told "it doesn't matter she won't remember any of this" I was appalled by this, they then did however manage to put a cannulla in her head!! Was awful.

My dd is now 22months and since that ordeal every hosp appointment we attend starts with tears at the hosp door...I'm certain she does remember! Unless you feel the tests are absolutely essential I wouldn't bother, what the hosp failed to tell me was that the tests could of waited till dd was 3!

Mosman Sun 10-Feb-13 07:42:33

A phlebotomist might have been a better bet they spend all day poking veins.

pamplem0usse Sun 10-Feb-13 07:44:41

hmm goodnees knows what theyre planning next if the ansesthetist couldnt manage :-( plebotamist has never managed to get a cannula in for blood tests either. they just repeatedly heel prick and drip blood into vial

yellowsheep Sun 10-Feb-13 07:59:25

It took 9 doctors and nurses to pin my son down to get his pre op blood he wad just 3 at the time we had been in hospital all day ans they has left it till 10pm he had been asleep for 4 hours if it wasn't vital I would have swung some punches most of the doctors came out of the room with my sons blood all over them
His consultant went mad and made sure after surgery every single one of the doctors and nurses came to apologise to him (a little 3 yr old) most brought a little present

yellowsheep Sun 10-Feb-13 08:01:39

Thankfully we are done with his treatment ans he only has yearly tests now but he has no problem about going for a blood test and still remembers the naughty doctors saying sorry they hurt him

I think you would be well within your rights to ask for the anaesthetist in the first instance, particularly since that would mean s/hehe would still have the easier veins available to him/her.

Poor baby, and poor you. Hope you get a solution soon.

Sirzy Sun 10-Feb-13 08:20:36

That's awful. When DS was 8 weeks old the doctor struggled with one of his cannulas (was in his foot at this stage) so stopped after 2 attempts and found someone senior to do it who did it first time.

No way should they be prodding and poking for that long. Do you have a children's hospital easily accessible from where you live? Could you be reffered there?

GirlOutNumbered Sun 10-Feb-13 08:22:53

It took a nurse six goes with a heel prick test when my ds2 was 6 weeks old and then tried with a cannula.. Then I had a call saying the blood was useless and could I go in again.
I did and refused to let a nurse do it. A doctor came and inserted the cannula firt time.

HollyBerryBush Sun 10-Feb-13 08:22:56

hes had chronic diarreah for ten weeks and blood in his stools.

I'd call that pretty serious at 4 months.

EasilyBored Sun 10-Feb-13 08:32:25

That is horrific. Please speak to PALS, no one should have to go through that. DS had to have loads of blood taken at three days old because of jaundice and I thought that was hellish, and everyone (bar one idiot a and e Dr) was so kind andapologetic about having to hurt him.

When he goes in again, set a limit before they start, two attempts before they have to get a senior and only x attempts total. Try not to let them pressure you. Poor baby and poor you!

ledkr Sun 10-Feb-13 08:33:44

I had a very poorly ds years ago and he had many many procedures. I became very good at gauging what was acceptable and speaking up for my babies.
Dd had pneumonia at 6 days and a junior dr was trying to put a cannula in for a while (maybe 15 mins) I then told her to leave it whilst I fed her and calmed her down. I had to be very assertive.
Half an hour later a senior sho came and put one in in seconds.
Don't feel bad now but in future remember unless its an emergency you can call a hault when you think it's enough.
You won't get a vein in a distressed dehydrated child either as the veins contract.
I have noticed over the years that some medics think they can do what they like to a child that can't refuse.
Definitely complain as well.

dikkertjedap Sun 10-Feb-13 08:34:09

Poor you and poor little ds. Especially horrific for you as you will keep remembering this, whilst your ds will forget it.

It does sound though that he really needs to be checked out. Was this a children's hospital or ordinary hospital? If the latter, I would insist on a referral to a children's hospital.

Once, you go in again I would explain clearly what happened last time and ask them for their plan and personally I would insist on their most experienced person available (i.e. no junior doctors).

Unfortunately, junior doctors are still learning and some don't know when to stop and are not told when to stop by their supervisor either. I am afraid I have been there with my dc, it is horrific.

I feel for you, many many years later I can still remember several incidents as they happened yesterday - I think it stays with you for life.

jjuice Sun 10-Feb-13 08:37:58

When I needed a blood transfusion the dr and registrar tried for about an hour..in the end it was a nurse that did it first attempt. Apparently because she does it way more often than a dr needs to.

My ds had mucus diarrhea when he was tiny and blood once. They never found out why. Detective jjuice did though. Milk intolerance! !

cyanarasamba Sun 10-Feb-13 08:41:35

That's awful, I'm so sorry you had to go through that, and that it's not yet over for you.

My DD had regular cannulations in her first year, and went through a very difficult chubby/ poor veins phase. A German doctor suggested using a vein on her scalp - apparently this is routine through much of Europe for babies under a year. I was initially revolted by the idea but we went ahead, it was very easy and the line was kept out of her way during treatment. They went in on the side of her head a few inches above her ear.

Might be worth mentioning when you return to the hospital if this hasn't already been considered?

QueenoftheHolly Sun 10-Feb-13 08:43:17

Poor you and poor little baby!
I hate it when male egotistical medical staff kind of bully mothers into things for their children by somehow implying that you're being a weak/soft mother who doesn't have best interests of the child at heart.

In a similar way I ended up having my epidural re sighted a couple if times after it completely failed during hormone induced horrific contractions.
The midwives were luckily really firm with the anaesthetist at the time & made him wait for the (few second!) gaps before doing anything. I remember one saying "she is in pain" & he said "yes but she's been saying that for ages now " shock
I felt guilty at the time but now feel cross about whole situ.

It all seems to link with the problem of certain hospital staff lacking basic kindness & humanity - to get a bunch of such people at once as you did seems shocking & even more so when it concerns a baby. Definitely go somewhere else if you possibly can.

Pobblewhohasnotoes Sun 10-Feb-13 08:46:53

That's awful, and I'm saying that as a nurse. We allow three attempts then find someone else. Trying for four hours is ridiculous. I would not allow this to happen again.

Babies are difficult to cannulate due to their chub, it's true. The anaesthetist is usually a last resort. Phlebotomists don't exist for children but some hospitals do have assistants trained in cannulation & bloods, which is similar.

If you go in again I would refuse anyone junior go near him and want a plan if it fails. Did they use magic cream?

pamplem0usse Sun 10-Feb-13 11:21:27

For those who are interested in the medical background:
DS definitely has a milk and soy allergy. He's exclusively BF and these have been included, but despite other attempts at exclusions / a very many tests these symptoms persist. He's been tested for infections and various other things but we're drawing a blank.
Finally (on Monday) they suggested this procedure. One of the Drs suggested after the 4 hour trauma on Friday that it might be unnecessary, another said that for symptomatic individuals if it is the thing they're testing for then it has a mortality rate of 15% so needs doing urgently. This isn't a children's hospital. I'm thoroughly at the end of my tether :-( My older child is in nursery two days a week and I spend those days going between medical appoints to avoid dragging her along on the other days.
I had to leave the room on Friday to vomit it was so awful, and think they would have carried on trying indefinitely had I not said no. Then the consultant got cross with me because I was standing to change my DS's nappy on the cot and as I was finishing he told me quite severely to sit down. I said I was just finishing off and he said 'well what do you expect me to do then, stand?'. I have no confidence in this hospital, they've previously spent 1.5 hours dripping blood to fill vials from heel pricks taken from my son because a Registrar insisted 'he could do it' even when I'd explained many others had failed. The blood ended up clotted so I had to go in for a repeat anyway.
All my instincts say to insist on them speeding up the Great Ormand Street referral I was promised but I know it's just going to be another battle. And my HV was supposed to be providing ongoing support but she's forgotten to phone the last two weeks.

lotsofcheese Sun 10-Feb-13 11:28:49

What an awful experience for you & your DS.

In these circumstances, I'd be asking my GP to refer me to a tertiary centre/specialist children's hospital.

I hope you can get something sorted

FutTheShuckUp Sun 10-Feb-13 11:29:02

Magic cream is all good and well but that can cause the veins to effectively collapse and make cannulation nigh on impossible. Poor little man

BabyRoger Sun 10-Feb-13 11:35:56

How awful OP.

I would complain. Maybe next time they will think about what to do in advance.

My DS had to have a canula and op when he was just 3 weeks old. The doctor came to put in the canula for drip and her, me and the nurse who was helping sat down and discussed what was going to happen as it would be difficult. He was so tiny!

The nurse fed him sugar water stuff out of a little packet whilst the doctor got on with it. Failed the first time and said she would only try once more before deciding on the next course of action. It worked the second time.

I think your little one's (and yours) experience warrants a complaint. Poor wee thing.

Message withdrawn at poster's request.

Message withdrawn at poster's request.

Sirzy Sun 10-Feb-13 11:52:39

* I have no confidence in this hospital*

Please insist on being transferred elsewhere preferably to a Childrens hospital but if thats not an option just to a different hospital. You need to have confidence that your child is being treated correctly.

HugAndRoll Sun 10-Feb-13 12:27:57

What is the other thing they do in an emergency? I ask because on Monday (the day my baby had 17 needles for 1 successful cannula) I was informed that if they couldn't get a vein they would have to do something else which is "not very nice". They did give my ds lots of breaks but they had no choice, a line had to go in and I believe that saved his life as his heart rate was dangerously high and he was completely dehydrated. When they took blood tests through the cannula his blood was thick and "dry".

I'm not condoning what happened to your LO op but do you think deep inside that it was just a case of they didn't want to be defeated or that it was the lesser of two evils as in my ds case?

HugAndRoll Sun 10-Feb-13 12:29:03

By the way this was in a children's hospital and cannulation was attempted by 2 nurses (one a surgical staff nurse), 2 doctors and a consultant surgeon.

FutTheShuckUp Sun 10-Feb-13 12:30:13

Inraoessuous which goes through the bone is one option.

HugAndRoll Sun 10-Feb-13 12:33:49

Thanks fut off to google that now.

ledkr Sun 10-Feb-13 12:34:31

Or a Hickman line? It's different in an emergency of course but its still ethical to consider the patients pain no matter how young.
I had chemo and towards the end my veins were knackered. I had to sit with my arm in warm water and drink loads to make the veins more plump. Now I can only have needles on my left side so it's always a struggle but they don't just keep digging.

FutTheShuckUp Sun 10-Feb-13 12:34:50

Ive most probably spelt it shite lol

HugAndRoll Sun 10-Feb-13 12:37:08

That doesn't look pleasant. Glad they managed to get a line in eventually.

Pobblewhohasnotoes Sun 10-Feb-13 12:37:42

FutTheShuckUp Sun 10-Feb-13 12:30:13
Inraoessuous which goes through the bone is one option.

Not for a standard procedure it isn't! It's a horrible thing and leaves a scar and is used in an emergency when unable to get fluids into someone.

FutTheShuckUp Sun 10-Feb-13 12:39:26

I didnt say it was an option for a standard procedure did I? I was responding to HugandRolls post asking what the other option in an emergency situation was...

FutTheShuckUp Sun 10-Feb-13 12:42:32

And as a qualified paeds nurse I do have a some idea about access in emergency situations...

VivaLeBeaver Sun 10-Feb-13 12:43:31

Intraosseous access sounds a bit horrific but I'm assured by a colleague its no more painful than ordinary cannulation. He used one of the "bone guns" on himself to see what it felt like and said it was fine.

Pobblewhohasnotoes Sun 10-Feb-13 12:44:33

And as a qualified paeds nurse I do have a some idea about access in emergency situations...

Yup and I'm a qualified paeds nurse too, and don't think it's a solution.

FutTheShuckUp Sun 10-Feb-13 12:45:18

Ouch viva what a weirdo! The noise it makes when its sited is bad enough to put me off!

FutTheShuckUp Sun 10-Feb-13 12:46:20

You dont think its a solution when a child needs fluid resus and going to theatre for a CVC would cause considerable delay?

FutTheShuckUp Sun 10-Feb-13 12:48:35

What would your 'solution' be though? Bearing in mind the time implications and infection risk of a CVC for an acute emergency?

I thought it was obvious that Fut was answering this, What is the other thing they do in an emergency? I ask because on Monday (the day my baby had 17 needles for 1 successful cannula) I was informed that if they couldn't get a vein they would have to do something else which is "not very nice"

Intraosseous is taught as a likely way to give fluid to an infant in a resus situation on the PILS.

HugAndRoll Sun 10-Feb-13 12:58:47

pobble that response was for me as that was a very real solution on Monday for my ds. For him it was 17th time lucky for normal cannulation but it was literally a case of he HAD to have IV fluid and antibiotics or I may not have brought him home on Friday.

HugAndRoll Sun 10-Feb-13 12:59:51

Sorry to hijack your thread op.

FutTheShuckUp Sun 10-Feb-13 13:00:12

It is recommended in an emergency as the second choice of access if venous access isn't possible as stated in the Resuscitation Council Guidelines

Teapot13 Sun 10-Feb-13 13:00:38

I don't think they can use numbing cream on under 1's. They sometimes try it but it causes reactions that make it harder to see the veins.

I know from experience with DD that it can extremely difficult to get a vein in a small baby -- even for an experienced, competent person -- but 4 hours is way out of order. I would definitely complain and demand a new plan when they try again.

FutTheShuckUp Sun 10-Feb-13 13:02:34

You would think after all the medical advances we have seen over the past twenty years at least they would have come up with an easier way to cannulate babies!!

I think you should complain OP, that sounds awful.you don't need to put in a formal complaint if you don't wish to. Have a chat with the PALS team and push for the referral to G.O.S.

Hop your DS is OK Hug?

HugAndRoll Sun 10-Feb-13 13:14:57

He's home but still poorly. Can't keep food or milk down still only juice. He's vomited every day since last Sunday. He's lost 2lbs already sad. He has severe rotavirus and I was told it could linger but I don't know when to worry about not keeping food or milk down, he can't live off juice only long term (although that's an improvement and has only been since Friday).

dorapeppageorgenoddy Sun 10-Feb-13 13:28:05

Don't go back get the referral either to GOSH or another hospital with dedicated children's section - lots of hospitals have dedicated children's a and e, could a visit there speed up a referral if he is poorly? Who on Monday go to GP and explain and insist on a plan, phone Hv to explain the situation -

My little one 17 months at the time became very ill while in hospital and had to be held down to get the cannula in, they asked me to leave in the end cause he had to have it and it was horrid watching his eyes look at me, like why are you letting them do this - but it was 20 mins or so when they managed to get one in, they tried once more as he did need two but the consultant called it off and said let's let him calm down and can assess later - But what made it ok in this situation was I knew he needed it as he was in HDU and the drip was the next stage to get the right medicine in - it must have been very upsetting for you in a non emergency with such a young baby -

Draft a letter and talk about the experience with loved ones just to air it so you start to feel better -

I'm no sure of the medical history but hope you are ok and your baby gets answers soon -

SandCastlesGoSquash Sun 10-Feb-13 14:25:06

It should not take that long. My DS was 10 weeks premature, and changing the cannula in his hand never took more than 3 goes, and that is with tiny premature veins. They are incompetent, I would go to a different hospital, and write a complaint to the original hospital. if it takes more than 3 goes for someone next time, ask if someone else can try. Poor you and poor DS sad

I know exactly how you are feeling.

Dd who is 16 months old had to have a blood test 2 weeks ago, I had to ask them to stop after 7 attempts!

2 person tried including the registrar, he even tried to get a vein where no numbing cream was applied hmm

Even though I asked them to stop, he was asking me to let him try again which I refused.

We rebooked the appointment and the 2nd time they had someone to distract her and they managed it on the 1st attempt (it wasn't without any tears though).

The bruises on her hands from the 1st attempt are only just fading away.

Ask them to stop if you don't feel comfortable with them carrying on!

MorganLeFey Sun 10-Feb-13 17:49:40

SandCastlesGoSquash = My DS was 10 weeks premature, and changing the cannula in his hand never took more than 3 goes, and that is with tiny premature veins. They are incompetent...

No. It's a skill done by people not robots & sometimes, unfortunately, is just difficult - merely being unable to site any cannula does not make them incompetent.
Sometimes departments have an infra-red type light that can help show impossible to feel veins up through limbs but once they're bruised it's harder to use.
& as people have said in emergency situations there is the Plan B option of intraosseous (through bone rather than vein) access for resuscitation.

Even in grown people I've come across scenarios where even anaesthetists using an ultrasound machines to try to find veins can't get baby sized drips into them (so it's not about junior doctors just being rubbish - sure some are but they don't usually let them try on children!) so you have to go to plan Bs of putting them into neck veins or arteries or longer lines using other methods of imaging to guide in theatre or the bone thing in adults too in an emergency.

What you could say is incompetent or unprofessional is how it's responded too though... & if it's not an emergency & parent & child are distressed you obviously need to communicate & think of a Plan B - which may be taking a break (for both parties & some parents preferred child to go with a nurse instead of them) / alternative distraction/numbing strategies depending on age or rescheduling. In hospitals I've worked there's no way we'd try that long in one session - although missing the investigation slot would also be a time limiting factor too!

FutTheShuckUp Sun 10-Feb-13 18:05:14

Exactly Morgan. Was going to argue that but cba with being told I didn't know what I was on about. It can be hard enough to cannulate a child with good veins let alone a flat dehydrated baby.

soverytiredofthis Sun 10-Feb-13 18:11:27

sometimes only the Doc's from neonatal unit can deal with chubby limbs. We had this several times with DD when she was 4 months old.

Insist on a Doc from this unit being called next time they fail. our hospital has a 2 strikes and your out system. They then have to call another Doc.

ScillyCow Sun 10-Feb-13 18:15:22

I stopped the Junior DOc after 4 attempts with DS when he was 14 months old.

The next doc who came managed it first time. I feel like I got off very lightly after reading all these stories
sad

That's awful. Dd was in hosp at 12 days and had to have one put in her arm. Doc struggled a bit and next time a nurse did it no probs, dd didn't even wake up. With the doc she had to be held down and by the time it was over she couldn't even cry anymore she just mewed and shook. It was the most horrendous thing I've ever gone through. My dh had to hold her down while I sobbed like a loon.

willesden Sun 10-Feb-13 18:56:56

In my experience, nurses are a thousand times better at finding veins than doctors. A casualty nurse would have done it in seconds. Does like too many egos at work here. Poor little baby.

MorganLeFey Sun 10-Feb-13 19:30:00

Please let me know where casualty nurses superhumanly cannulate paediatric (especially infant) patients & I'll direct all my Paeds junior doctor friends there for locums! smile

Neonatology ANP's on the otherhand - can be pretty damn good although perhaps it's not a fair like for like comparison to pit them against a rotating junior doctor in neonates. Although when they don't get it the escalation is then back to a doctor to try so those rotating juniors who are going to be the Paeds/Neonatal/Anaes SpR then Consultant some day do need to gain experience. Sometimes doctors are rubbish at 'easy' ones because they only ever get called to do the weird & wonderful - after care of the elderly/paediatric jobs it took me a while to get back into the swing of big man/women in labour veins!

Don't think any hospital I've worked in has had a 'policy' on how many times one HCP should try - I think it's situation dependent on why they're failing, if there are still veins to be tried & the urgency of the situation/availability of senior support. 2-3 attempts (WITH patient / parent agreement) would generally be my max though & sometimes I've escalated after 1 if there's nowhere else to be seen - resulting in some of the anaethetist with ultrasound machine/going to theatre scenarios.

SilverSixpence Sun 10-Feb-13 19:53:25

Yanbu, I have been in the position of having to put cannulas in babies and would certainly not have tried more than 3 times myself before calling someone more senior. It's v v distressing (can be for the doctor too!). If its medically essential then I can see why the anaesthetist was called but if they had tried for so long then ywnbu to ask them to stop.

pookamoo Mon 11-Feb-13 10:14:31

My 5 week old DD2 had to have blood taken, and as the nurses held her down and she screamed they said "it doesn't hurt her, she just doesn't like being held down" Like fuck she doesn't. angry

I think you should definitely be speaking to PALS and getting your GP to see if they can refer you somewhere else.

Huge hugs to you and DS.

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