Sedation for blood test for teenager?

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Has anyone’s teenager been given nasal or other sedation at an NHS hospital to allow a blood test to be administered to a severely phobic teen? Our son needs blood tests but has a severe phobia of fainting during/after the procedure, after having fainted before. I’m not sure that all the CBT, distraction, preparation and other techniques he’s trying are going to be enough. Thank you.

Hi OP - I had /have the same phobia! Massive fainter and terrified of fainting again and absolutely hate blood tests because the make me faint. But I’ve had about 30 now and get better every time.

I have them every 6 months and am able to do it without sedation and without fainting, it’s hard mentally but absolutely doable. I used to sob, hyperventilate, and my eyes would roll like a terrified horse. Now I just breathe a bit fast and hard.

Applied tension techniques help. Make sure they let him lay down for it and have a fan blowing on him. Most important - he has to try and talk all the way through. It engages the brain and stops you slipping away into the faint.

The techniques absolutely work. There’s also something to be said for accepting the faint. That it could happen but you’re in the best place for it - a hospital surrounded by healthcare workers. That’s it’s ok if it happens. Even if everything inside you doesnt want to.

@Lemonade2011 thank you for your kind reply. A few people on here have suggest things like rescue remedy / Kalms (thanks everyone ) so that might be something for me to look at next time. Really appreciate you sharing your perspective - I can tell you’re a lovely nurse! His nurses are fantastic as well.
Thanks again.

DD has been like that her entire life. I'm afraid I am another tough love advocate. No nonsense, put your big girl pants on. When they did multiple jabs at school she had two nurses, one either side, jabbing into each arm simultaneously with me holding her down.

A memorable blood test, multiple vials, were achieved by a fabulous nurse and DD singing musical songs at top volume. They got a round of applause at the end.

One thing that might work is exposure therapy. Reading about, looking at, watching people have blood tests. DD (anxious as you can see), overcame her aversion to dead bodies with exposure therapy. It works.

My worst one let the needle slip out and blood sprayed everywhere and then she showed me the blood on my arm 🤦🏼‍♀️ most aren’t that bad.

just a general thanks to most of you who’ve taken the time to send a thoughtful comment. I’m off to a meeting now but will have another look here later for any not helpful ideas.
Please don’t bother commenting however if you’re going to say something unkind. It’s not necessary, especially when we’re talking about a child here.

My dd has severe needle phobia, she was 14 last time she needed a blood test and in the end the nurse had to take it with her screaming her head off.

I don’t think you’ll get a Dr to agree to sedating a child due to the risks involved. I think I’d just keep making appointments and taking him, use loads of distractions, make sure he’s eaten and drink lots before hand.

My dd and I are both fainters, there are certain exercises you can do to reduce your risk of fainting. It’s not nice but he won’t die (which I suspect is the actual fear.)

Also OP, make sure he drinks litres of water ahead of the test. Makes the blood come out faster so the whole process is done sooner. And make him eat before hand and have something sugary for straight after.

You need to discuss with the requesting doctor to decide how necessary th bloods are. If essential they’ll need to work out the safest way to get the sample.

Sedation isn’t a straight forward solution, cannot be given by a phlebotomist and will massively increase the medicalisation of the process. As others have said many sedation options require a cannula which will obviously not be possible as more invasive than a blood test. Alternatives, eg gas and air, may well cause feelings akin to fainting.

Sometimes we’ve just got to do things we don’t want to/are terrified of, as trite as the oncology ward suggestion is, there is some truth to it isn’t there - those kids just can’t be needle phobic.

I had a really bad experience when I was a teen with a nurse trying and failing to take my blood multiple times and then I fainted afterwards. I was terrified of having it done again and really embarrassed at the thought that I might faint again if I did.

It stuck with me for years, but then I had to have multiple blood tests done due to infertility investigations and had no choice but to do it. Even now I still get really anxious beforehand, so I really empathise with him.

Would having it taken from his hand be any easier for him?

Would listening to music or something be helpful? One of my brothers has a phobia of the dentist and he's worked up to not using sedation by using noise cancelling headphones and meditation or music. It has taken a while but he can now tolerate the dentist to the point he now has braces and goes regularly for his check ups.

You have my sympathy OP. I have a child with a severe needle phobia and it is extremely challenging. I have tried many of the things suggested here and spent a lot of money on counselling without any success. One of the things that terrifies her the most is that someone might forcibly inject her. I haven't tried diazepam so maybe that would an option. Good luck!

My son is a fainter when having blood taken, less so now he's an adult (I think). He once fainted and hit his head so had to be kept in for observation 😬

Ironically he isn't scared of needles or blood tests in general. He has type 1 diabetes and injects many times a day.

It's something some people can't help when they have a blood test. Their blood pressure plummets and down they go.

All the PPs talking about tough love are being ridiculous.

I would recommend getting his fainting down on his records and lying with his feet above his head while having the blood test and for about 10 minutes afterwards. That should aid venous return and help stabilise his blood pressure.

Indeed; I have this and am reading the thread with interest to see if anyone has any good suggestions! I am nearly 40 and still haven’t solved it for myself unfortunately. I really do feel for your son and understand completely what he is going through. Contrary to other posts, lying down for a blood draw does NOT stop you from fainting if you suffer from vasovagal syncope (as I have often found to my cost!).

god what an absolute asshat you are. crawl back under your rock.

Fainting can happen - I've had it once happen to me when a doctor made such a hash of the job - I was on a ward having blood taken overnight for a test, and instead of sending me down to phlebotomy when they would have done it in two seconds, a doctor came and did it, and she was struggling to get it out of my hand because it had a cannula in it.
Another time, I started feeling light headed when another nurse was making a problem out of it. I have straightforward veins inside of my elbow, so they always do it there, and since I've never had a problem if they do it quickly.

Sorry if already been suggested but can dr prescribe an anti anxiety medication just for this one occasion? Like a prescription for just x2 or x3 pills? That should remove the panic

I agree with PP who said to de-catastrophise. So often it’s the thought of what might happen, that’s far worse than the actual reality. I give injections and take bloods and lots of people do struggle with it, so your DS isn’t alone, it’s doesn’t mean he’s being pathetic and nobody there will be judging him for fainting.

what tends to help my patients is certainly lying down - yes you can still faint lying down but at least you won’t fall and smash your face off the furniture. Also, I like to make the anxious patients talk to me - if you’re talking, you’re breathing, so not holding breath and tensing which then means your blood pressure drops into your boots after when you relax (common cause of fainting). So I ask lots of questions and get them thinking about that rather than what I’m doing. I also minimise fuss and get it done quickly and efficiently, then give plenty time after to recover before they try and stand up and leave.

fainting with blood tests isn’t some sort of moral failing, and can’t always be solved with tough love - I certainly couldn’t pin my 14yo DS down even if I wanted to! Was needed is calm, reassurance and time. I had a patient come back 3 times before we could get his injection done, and I’m glad we invested the time and effort, and by the finish so was he.

I encounter situations like this regularly as part of my job, so it is certainly something that does occur in practice. The patients I see most often have learning disabilities (LD) or are neurodivergent (ND); in fact, all patients I have treated within the past 12 months have fallen into these groups rather than presenting with a needle phobia.

Nasal sedation for a 14-year-old can be quite uncomfortable due to the volume of medication required. An alternative option is oral sedation, using medications such as midazolam, ketamine, temazepam, or diazepam. While these can be effective, they do carry potential side effects that some patients may find unpleasant, and there is a likelihood that your DS will experience a reduced sense of control.

Who has requested the blood tests? It maybe worth having a chat with the Paeds team to see if this an option in your Trust.

Would it be worth looking into hypnotherapy? That might be a long term solution.

As someone else suggested try an over the counter remedy for anxiety, even if it is just a placebo effect it might be worth it.

I was thinking hypnotherapy might be worth a try too.
Willpowders sell a supplement called calms that I would recommend too.

This is BS they do bloods every day in outpatients. A paeds clinic will also have access to more equipment, monitoring, numbing cream/cold spray, play specialists etc than phlebotomy.

I have cancer and have a lot of blood tests, have started fainting recently, poor kid has my sympathy and all the tough lovers on here are making me cringe.
I used diazepam to get myself through a dental phobia, sedation is hideous but a little bit of diazepam allowed me to be present with what was going on whilst not feeling anxious, so my brain learned not to worry. Suspect you’ll struggle to get a prescription but if you could, I feel fairly confident this would get you through. And as you say, over the counter meds like valerian may do the trick.

but aside from that he needs intrinsic motivation, he needs to want to do it. I would be considering offering cold hard cash. 50 quid for doing the blood test, another 50 quid if he faints. Everyone has a price! at least then he’s on the same side as you wanting to go and get it done.

Are you serious !

A teen I know is the same and I think they give her a whiff of gas . The one that's used for birth . It's worth asking about .

Yes.
I think the OP understood what I was asking.