Having blood taken trauma..hlp pls

[lelole]

Hi, My daughter who is just over 3 and a half has to have some blood taken. The Gp gave us some special anaesthetic cream for her inner elbow, and asked us to go up to the local paed outpatients to get it done.

To cut a long story short, we followed all of the advice such as be honest explain what is to happen take toys and treats etc. etc. and tried to make it as non traumatic for her as possible, but she was very scared of the idea from the beginning.

When we got there after a wait we were brought in with the nurse, who couldn't find the vein, so she then asked another more experienced colleague to come and do it, and they also brought a play therapist in (whose total input was to bring a pot of bubbles with her) and they tried again and again and no blood, all the while my little one was really agitated and traumatised. So we have been asked to go back on Thursday, and asked to pre - prepare 4 different sites with the anaesthetic cream.

The thing is she is so upset by it all, not herself, despite a trip to toys r us, and a lot of attention, and a mcdonalds afterwards... Really upset will not go to sleep etc. keeps asking if she will have to have her blood taken again with real fear in her eyes.

I just don't know what to do on Thursday, I don't know how to deal with it, any advice would be very much appreciated...

thanks

Leah

I would ask if they could get a phlebotomist to come and do it - or you go to them. In my experience, many nurses struggle to take blood samples, and if your daughter is unhappy about it they will struggle even more. There should be someone in the pathology department who takes bloods all the time, and they can usually take the sample very quickly, and with a minimum of fuss.

Poor girl, right, I used to take blood from kids, back of the hands is sometimes easier to find a vein on little ones so make sure you apply the cream there and on the insides of her elbows, its a shame they had to have multiple attemps, as now all the bubble blowing in the world wont take her mind off what they are going to do, do you know how much blood is needed? as if only a few mls is needed we would sometimes (depending on the tests) be able to get the blood from a fingerprick, it might be worth asking, though for certain tests blood cant be taken this way, another way to try and ensure the whole thing goes as well as possible is to make sure she is being held properly, a wriggling twisting child is very difficult to get blood out of, and sometimes even if a vein is found, if the arm twists it will bruise and refuse to bleed, you could try and hold her in a bear hug with her arm behind your back, with somebody else behind you holding her arm steady, I really hope it goes much better this time, and that they manage to get the blood fast with the least amount of upset to your little one

In childrens outpatients the phlebotomists should have been experienced, but dont feel bad for asking for someone more experienced, in our team some people had a knack for the teeny babies, while others were much happier taking blood from older children.

Hi,

Thansk for your replies. I actually don't know if the people who took the blood were phlebotomists - I just assumed they were nurses...

I think that they will have to take actual blood, as they are testing for celiac, and a load of other problems, as dd has had chronic diarhhea, and is short for her age.

Actually she didn't scream and struggle, that's not really her way, she sat on my lap, but was very emotionally distraught. She's quite a emotionally sensitive and bright little girl, and I think that's the problem. For instance, she has been worrying this evening that if she takes the plaster off, the blood will fall out of her arm and that kind of thing.

I will ask for the most experienced person though... I didn't feel like the people today were all that experienced, and I do wish now that I had stuck to my instincts and asked them to just try on her hand or something even though it was not anaesthetised...Because I just think, since she was there already, and now she has to go through it all again, when it could have been done and forgotten.

I am not sure whether I should tell her we are going this time? My instinct was to just tell her an hour or so before, but I think that as soon as I put the cream patches on her, that she will rip them off etc. Apparently they need to be on for an hour or so before to work.

Is there any chance we can get some kind of sedation do you think?

Thnaks, Leah

Bless her, its not nice at all, especially when you are 3, it sounds from the tests she needs that it will need to be a sample from a vein, with regards to the cream, it might be worth asking if the numbing spray is available (Ethyl-Chloride) this was just starting to be used more when I left the hospital I worked at, and is just sprayed 30 seconds or so before the test, and takes the sting out of the blood test, this might be better for her that waiting for the to work? I dont know if its used in all hospitals though?

definatley ask for the paediatric phlebotomist, honestly they are genuius they managed to get blood from my very prem baby when the consultants failed.
I always ask for them to get ds2's blood now.

They tend to be much quicker, I always go for the quick no fuss technique. I hold him down & still while they do the business.

I also don't bother with the cream but ask for the "freeze spray"
Basically just a very cold spray that acts instantly so no need to prep areas.

DS2 usually rips the plaster off within half an hour, not the recomended time I know but the plaster is actually the worst bit for him.

Good luck.

Hi Thanks for the support. am OK with it, and relatively calm around her, but it's the distress it is causing her which I don't like.

I kind of assumed it would be pretty quick too, like when we have had vaccinations for her, and I do think it was time it took that caused the problem we were probably in there ten minutes...

I am not sure whether they have the freeze spray as the whole reason we have to go back is because they felt it would be better for her to go home and come back with more cream patches, rather than stay and wait for another to kick in - I think they would have offered the spray if they had it.

The appointment time I made is not actually suitable so I will ask if we can make a specific appt with the paediatric phlebotomist if they have one, because I do think it should be as quick as poss...

I did chat to her today about the idea that she may have to go and have more blood "one day" and asked if she would like to take her bunny flopsy with her next time and for flopsy to have it done first so she could see, but she burst into tears and said "no, flopsy would fall apart and break cos he's not real"...so I think that may not be so good!!

I guess we just have to grin and bear it, but it feels like I am traumatising her for life!! I think I will let her know an hour or two beforehand, so at least she won't worry about it for days...

Thanks,

Leah

PS, she also insists that it really hurt, and when I asked her how it felt she said something sharp going into my body, so I don't know whether she is just saying it or whether the cream didn't work? I really don't think I will be able to persuade her that it won't hurt next time...

Leah x

When DS needed bloods taken I got him to sit on my lap but facing me ( astride iyswim) and then read a very animated picture story to him over his right side while the phlebotomist took blood from the left, so that he wasn't looking her way.

It was over very fast, but he was in a real state beforehand.

horrible for your DD, freeze spray sounds like a good suggestion.
Hope she's OK

The cream has never seemed to work with ds either.

In fact we have to go to an appointment tomorrow where he wil probably have to have blood taken and he is already dreading it .

Definitely agree with pin them down (gently but firmly) and try to get it over with asap - it is tricky with an 8yr old with long legs though!

I don't talk about it too much with ds anymore as I find he gets more wound up. I do try to talk about something nice that will happen afterwards - trip to the cafe/toy shop/tea with a friend as a distraction.

Good luck. Just console yourself that it has to be done

Hi all, Just wanted to say thank you for all of the advice. I told my little girl after lunch, and the appt was at 3pm. She was really upset but I managed to get the cream on her while she was playing on the cbeebies website!

It was mcuh quikcer this time, and although she was really upset, because it wasn't so traumatic, she got over it really quickly afterwards... i made sure we tallked about the fact that her body would make lots more blood to replace it, and some Disney princess plasters we took with us helped too!

It was quite nice in a weird sort of way, because you could see that when I told her how brave she had been and hpw proud I was of her doing something she was scared of, you could see she felt really proud of herself...

Thanks again, all of your advice really helped us both,

Leah