4 YO blood test tomorrow but traumatised from the last one

[firemanHam]

I had to take DD, at the time 3.5 for a blood test last November. It was horrific. They couldn't find a vein in her arms or hands so had to pin prick her toe & squeeze. She was begging them to stop & I could have cried. She was in ICU for 2 weeks at birth & had multiple blood tests, Lumbar punctures MRI's etc so you wouldn't think a blood test would bother me but I'm feeling terrified about tomorrow.

I haven't told her yet as I know she will overthink it, get very upset & won't sleep tonight. I called the bloods dept who will take the bloods & they said there's not a lot they can do to distract her whilst there. I took toys & an iPad last time but once she knew what was happening she just got too upset to keep still which made everything 10 x worse. It won't matter if I promise her a treat after either, she just hears the words 'blood test' & gets herself in such a state. Current plan is to tell her we have a hospital checkup & then once in the room ask the staff not to mention the specific words 'blood test' & wonder if I can distract her enough whilst they hopefully find a vein & spray with the numbing spray 🤦‍♀️ I know it sounds totally unrealistic but she really is terrified & can't be rationalised with this. Anyone else have any tips or experienced similar? She's quite a hardy kid usually but just not with this!

Hi op where is the blood test to be done? Here they normally refer paediatrics to the children’s ward at the hospital where they have staff who are really experienced in managing blood tests in kids. Can you ask for a referral to somewhere similar?

I had a simmilar trauma with DS 4 who had a terrible experience with a cannula in a&e then had to have repeat blood test and being with the children’s nurses made a big difference. They left us to the end of the clinic so that they could take as long as they needed and they made sure they had the right staff in the room first. It went a lot better than I expected to be honest.

Also you mention the spray - have you been offered the cream? DD has regular cannulas and hates the spray- she says it’s worse that the needle… the cream is a lot better. Ask if you can have some in advance so you can apply it ahead of time so it’s really effective once you get to your appointment.

@1400spincycle Thank you for your reply! So this blood test will be done at the Paeds unit whereas the other one was at some random hospital. The staff there were great don't get me wrong but not sure if they were specialist in taking bloods from kids so I'm HOPING tomorrow will be better.. I tried to put the cream on her last time & she wiped it off as she was in such a state 🤦‍♀️ I suppose I will just have to turn up tomorrow & hope for the best. I just don't like feeling like I'm not telling her the full truth as to why we are going to the hospital. But I know if I do she will just get upset & wont sleep.

I really sympathise! My DC have to have yearly blood tests for a disease they have (will have to have blood tests for life). When they were little, they had to have blood tests for unrelated issues and it was horrible - we tried distraction techniques, magic cream, cold spray and bribery! My DD always faints, which is traumatising for her. I don’t have any advice but I totally get how hard it is. Is there a special treat, like swimming, you could encourage / bribe her with? Hope she’s ok with it x

Personally, I think honesty is the best policy. My 4yo has had to have lots of blood tests, cannulas, surgery etc, and I am always honest with her. Giving her some choices (cannula in hand or foot, cream, spray or nothing etc) helps make her feel less powerless. If you think she might need further bloods taken off anything else similar, then you need to be honest with her or she'll not trust you for medical appointments again. If it's likely to be a one off, you might get away with it more. We also tell her about appointments in advance which helps.

Good luck.

Absolutely agree with honesty being the best policy. Having been the child that wasn’t told what was going on and been traumatised by that, and now being a HCP that has to manage children who haven’t been told what’s going on…. It really just makes things worse in the long run. They won’t get the numbing spray on without her noticing (because it’s so cold and to get it working properly you have to use quite a bit). A paeds unit will have play therapists who can be really helpful for things like this…worth asking to see them early on.

Yes I would agree with honesty. I told mine in the morning of the test. Normally when doing the magic cream.

The risk in not telling her is that she will become as desperately upset at any and every doctor's appointment as she does having her bloods taken, as she will never believe you again that she's not having bloods taken. I've seen that happen.

The only advice I'd give is put the numbing cream on whilst she's calm, in the car park if you're driving.

It is horrible for the little ones isn't it but in my experience the paeds are fantastic so hopefully a better experience than last time.

Magic cream (Emla) is better for young children who are anxious.

And bribery all the way.

Magic cream is great; (unless you have a child like mine who's allergic to it. Luckily he thinks blood tests are fascinating and fun. Yes, you did read that right. He's normally quizzing the doctor about it as he faints, which is also fun for me apparently...) I think you need a prescription for it though.
Spray seemed not much better than placebo effect for any of mine.

What I found at that age the most effective method was:
Yes, tell them. Explain why in their terms. "The doctors need to look at your blood for X reason." Make it sound exciting that the doctor thinks they're amazing enough to look that their blood.
Tell them that afterwards you will do something that's a treat. (drink in the café was my normal one)
Put the cream on half an hour beforehand to give time to react.
Don't tell them they will feel nothing, or if they feel the tiniest movement they think you've lied.
In the 10 minutes before hand try and warm the area up (take a hot water bottle). The blood flows easier if it's warm.
When it come to it, take them into your lap facing each other. Get their arms (if doing in hands/elbows) behind you and hug them tightly. If they have a comfort item you can put that between you. Sometimes a chocolate button in the mouth is helpful too.
Talk to them while it's happening. A story, praise for being so good, just the sound of your voice is soothing for them.
When it's over, admire their plaster, tell them how brave they are, give them any comfort item to hug and go for that treat. Tell everyone how amazingly brave they are.

Thanks all. We haven't been given any numbing cream. Not sure if we will tomorrow but like I say last time she was scrubbing it off her arm.

I absolutely agree that if I lie tomorrow she will never trust me for any medical apps again. The issue I have is I know her & the minute I tell her she will just cry & be terrified. She's a very sensitive kid & one of these where something hurts every day, be in her head, knee, stomach, toe, hand! She has a ridiculous memory. For example today she practised for Sports day at PS & cried almost the whole time as she was telling her teachers about last year with an almost photographic memory (from what they told me) & she hated it last year so now hates even just practising for this year, if that makes sense. Hence if I even mention I'm going for a blood test, she gets panicked & says 'I'm not having a blood test!' It's just like the panic is instant. Thank you all for your replies, they are massively appreciated.

I wouldn't go with cream as it increases the anxiety as they know what is happening. Do not show your anxiety at all be bright and breezy.
Before hand make sure she drinks loads as if hydrated veins easier to find.

Yes we use numbing cream. Collect from pharmacy and it’s put on with clear plaster onto an hour beforehand.
My 3 year old wasn’t impressed either recently, but we explained what it was for etc.
I think he may have been a bit dehydrated as took ages getting enough blood out! Which he wasn’t impressed with. So I suggest getting her to drink lots beforehand.

Paeds nurse, definitely honesty. And enlist the help of a play specialist. Though ours are crap and few and far between, so to be honest we forget to get them involved. So do ask for one. If you hate needles eat your self, please don't let your child pick this up. Nothing worse than a child who is calm until they see how their parent is reacting when the needles appear. Good luck.