Emla cream doesn't work?

[NowIveSeenEverything]

Named changed because outing. Dd3 went for blood tests today at hospital. I applied the emla cream as specified 1 hour before, and covered - this is not my first rodeo, ive done this for ds6 several times and it's worked fine - and the pain was like nothing ive ever heard from her. This is a girl who giggled during her 3yr vaccines a few months ago. She is not a drama queen (unlike her big brother who sounds like someone has chopped off a limb when he's scratched himself or dropped a crisp...).

The hospital staff said that occasionally it just doesn't work for some people, the application was fine. Im hoping to find other parents/people with the same insensitivity (is that the right term?) and their solutions for pain relief for these minor medical procedures. Dd is a (largely) very healthy and non accident prone girl, but there might be more tests coming up, including scans, scopes, etc. I'd like to know what to say to medical professionals to make sure she gets pain relief that works for her. Lidocaine cream works on me and dh (her dad).

Also to add, she is not a red head (I know there is a genetic trait here with pain relief meds), but her grandma is.

Can I ask whether it was a specialist paediatric nurse who did the blood test? My 8 year old has had a range of annual blood tests since she was six months, and has never had any issue - I don't think we've ever even been offered any type of pain relief! But this is always under specialist paediatric care. I know that the techniques are quite different for small children so was wondering whether that might be the issue and you could ask next time for someone with experience of taking blood from children?

It was at the children's centre at the hospital, so i assume so? 2 medical staff in the room who were solely doing blood tests on small children, I didnt hear a peep from the 5 before us (all the kids who saw them had their emla cream on in the waiting room).

Edit to say they were both very good with her, calming and distracting, and had a basket of teddies for her to pick from after 😅 They used the same techniques and positions as ive done upstairs on paediatric ward with ds many times, I don't think it was them? That's a good point though, ive had some horrific blood tests, but at the GP.

I would also consider the possibility that the person doing the blood draw wasn’t particularly good at their job. I’ve had my blood drawn hundreds of times and skill varies wildly.

there is a buzzy bee thing that works for some people.

Both my children have had lots of blood tests with no emla and neither found it worse than a small scratch. It really sounds like the nurses did not do a good job if it was so sore.

Oh no really? I feel awful for her now, poor thing :(

There's a numbing spray they can do at the time that might help a bit.

Was it a difficult draw, or relatively quick but still very painful? My youngest is tricky to get blood from – small, slippery veins, and even once they find one they're happy to use, it can take a long time because the blood is coming that slowly, or just stops and we need to go again in a different spot. I don't think it's any reflection on the nursing staff in her case – everyone has the same issues with her. It's just really hard.

My only tip besides the numbing spray is if you ever need inpatient bloods – we have the option of going into another room for tricky procedures (assuming well enough) so that the bedspace remains 'safe', and I find that really helpful.

I’m a nurse. If all the other patients were fine then it’s unlikely to be technique related. Some people just don’t respond well to local anaesthetic and venepuncture can be painful, especially when you’re not expecting it. She’s not double jointed/hypermobile, is she? There’s a definite link between hypermobility and insensitivity to local anaesthetic. Has she had local anaesthetic before, for example at the dentist?

If it was the back of the hand, it's possible they hit a nerve, I've been caught that way a couple of times, as a kid and an adult. But never in the elbow crease. Elma didn't work for me as a kid, and I hated the smell after that and associated it with unpleasant things, so turned it down (I was 12, so big enough to say no). My daughter had the freezing spray for a vaccine which seemed to work, but would imagine that's not an option for a blood test or cannula placement as you don't want the vessels constricting with the cold. I think going forward it may need to be a ton of distraction plus her favourite treat immediately afterwards, so that you build positive associations. To this day I buy myself a twix after any procedure or bad news at the hospital- something my dad started when I was 12!

Edited to say, all local anaesthetic injections at the dentist and for skin procedures and eye operations work fine for me. So it's just the cream that did nothing. Hopefully it will be the same for your DD.

It was a quick and easy draw, her elbow veins were already massive.

Not that I know of, but her brother might be. He's double jointed and has recently had hand surgery for trigger finger, prompted by a fall. She's never had anything at all before except an anti emetic liquid once.

No it was in the elbow joint, and her veins there are very large.