Preparing SPD 3yo for blood draw - Mothering Forums

 
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#1 of 12 Old 09-16-2009, 11:21 PM - Thread Starter
 
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DD has to have a blood draw tomorrow. I am starting to worry. A lot. I have been dreading it and putting it off but it has become necessary. She has not had one yet.

I have the EMLA cream, and there is a NP at our peds office who used to be a NICU nurse and she has promised to be there to do the draw.

I will also have my totally rambunctious 1 year old with us.

Seriously, I have no idea how we are going to get through this. She has never had a needle in her, since her heel prick as a newborn.

Does anyone have any advice for me?

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#2 of 12 Old 09-16-2009, 11:30 PM
 
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Definitely use the EMLA cream, it really does work. But make sure you put it on at least 1 hour before the needle. Is there anyone at all that can watch your 1 year old? I wouldn't be able to handle the bloodwork with my son if I had to watch my other kids. For the longest time he wanted to be on my lap and there were two technician's to help as well. If you are having to hold your 1 year old then you will not be able to be right there any involved. Hold her really firmly and talk to her about something you're going to do later. Other tips are to distract as much as you can during the procedure. Keep her looking away from her arm, away from the needle. Also, bribery goes a long way. The first 10 times or so (my son gets bloodwork alot) I promised him a prize of some type as soon as it was done. And no, that was not a prize if he did a good job, it was a prize no matter what, because getting through bloodwork is tough. So we would go to a bookstore or go pick out some stickers or a small toy. Sometimes he chose to go to Mcdonald's as his prize and I was fine with it. I hope it goes okay!

Shawna, married to Michael, mommy to Elijah 1/18/01, Olivia 11/9/02, and Eliana 1/22/06
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#3 of 12 Old 09-16-2009, 11:38 PM
 
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well, if there is ANY way to go without the one year-old, i would. or bring something to distract him (even a dvd, if it'd work). or see if an office person could read him a book.
if he weren't in the equation, my advice would be:
-give her a brief, neutral explanation about it the morning of the blood draw. "we're going to the doctor today, and they're going to poke your arm really quickly with a needle. as soon as they're done, then they cover it with a cool bandaid and you're done." depending on how you feel about reward stuff, you can tell her that afterward she can get a special smoothie on the way home, etc. you can show her by pretending on your own arm, or letting her pretend on herself.
-when you get to the doctor's, keep her occupied with things she feels comfortable with (reading, drawing, whatever). don't let her stew in thoughts of what's about to happen.
-i'd hold her, in my lap, and be the one to hold down her other arm. my dd felt safer that way.
-i think over-talking/over-prepping can cause a lot of anxiety, though i certainly believe in telling a kid the age-appropriate truth.
i used to be a pediatric nurse, and the parents who were cool and calm had kids who tolerated everything better. easier said than done, i know from experience. it really will be over very quickly, and she'll be okay. . good luck, mama!
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#4 of 12 Old 09-16-2009, 11:42 PM
 
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Try to stay calm yourself - she will sense your anxiety and be more worried. It's great that you have set it up with someone who has experience with little ones. My son is a hard draw and it has been suggested to use a warming pack to make it easier to find the vein. He just hates to have it on his arm so we haven't done that successfully yet but it is worth a try.

Distract her while it is being done - sing a song or just talk out loud about something she loves to do. It will be over before you know it and you will realize that the anticipation is worse than the event!
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#5 of 12 Old 09-17-2009, 12:03 AM
 
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I am assuming you have proper instructions for the EMLA cream but just in case, it has to be placed under an air tight bandage. When I used it, I applied it to the skin in a moderately thick layer, then placed a square of plastic wrap over it, then taped it with medical tape. I also placed it at two different sites. It happens that they can't get a successful draw the first time and have to use a different vein, so if you are prepared with at least two spots, you've got that situation covered.

I agree about your level of anxiety. If visualizations work for you, take a few deep breaths and picture yourself calm and peaceful and sending out calm energy.

Good luck!

"To err is human, to forgive, canine." - Unknown
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#6 of 12 Old 09-17-2009, 12:15 AM
 
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Practice at home first so she knows what to expect... poke with something little but not too sharp - don't draw blood for real of course, its just to give an idea of a pinch that might hurt, but thats over with in a few seconds, then afterwards, practice by putting on a bandaid. Do it a few times and explain that this is similar to what will happen on that day. This way it won't seem quite so scary or such a "new" experience.

If you Have to take the 1 year old, bring a little umbrella stroller along, and put him/her in it with a new toy to distract during this experience, so you can be with your daughter during this time.

ETA: I just saw where your appt was tomorrow. You don't have a lot of time to prepare, but I guess even one practice run that morning, would be better than nothing. I feel your anxiety.. if it helps any, my son had to have one at 1 yr old (routine lead and anemia test) and I held him in my lap, while DH distracted him, the discomfort lasts only a few seconds until the needle is in... once its in, there is no pain during time blood goes into vials. Holding arm still as possible helps of course! I thought it would go much worse than that, so I was relieved. There were 2 workers there, one drawing the blood and one assistant to help with holding his arm.

"All that is necessary for the triumph of evil is that good men do nothing." -Edmund Burke (1729-1797)
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#7 of 12 Old 09-17-2009, 02:22 PM - Thread Starter
 
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We're back. I really appreciate all of your suggestions. I briefly talked to her last night and this morning and let her practice on me. I think overall the preparation was as good as it could have been.

I was really calm and truly felt like it would not be too awful by the time we got there.

Unfortunately they tried twice and were unsuccessful - the nurse could hardly find a vein. The two that she found rolled.

It was pretty much horrible. By the end DD was incapacitated and screaming hysterically. She is in kind of a sensory withdrawal right now. Lying on the couch with her pacifier, wrapped in a blanket. She refuses to use any of her limbs.


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#8 of 12 Old 09-17-2009, 03:32 PM
 
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oh, gosh, i am SO sorry to hear that . i thought of you guys this morning, and hoped you'd let us know how it went. sounds like she would've done great, but missing the vein twice is just too much. boooooo.
did she get any treat afterward, or is all just too much right now?
i hope the rest of your/her day gets much better. hugs.
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#9 of 12 Old 09-17-2009, 03:35 PM
 
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Oh wow! I am so sorry it went badly. It's really lousy when you do all you possibly can to make something go the very best way possible and it all falls apart anyway. Hugs to you both!

"To err is human, to forgive, canine." - Unknown
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#10 of 12 Old 09-17-2009, 04:52 PM
 
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Oh I'm sorry it went so badly.

Mom to ds 9 dd 7 : and dd 3/08 : if I can I go to
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#11 of 12 Old 09-18-2009, 03:35 AM
 
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Oh man! That is just awful - that is not the way it was supposed to be!! I am so sad for you and for her! I don't know what it means "rolled" ... did they try to locate a vein BEFORE poking the needle in? I recall them putting on tight gumband thing, and looking and feeling the arm well to locate a vein before doing needle. I am wondering if maybe this was an inexperienced nurse problem, or if truly she does have hard veins to find. I am so sorry!

"All that is necessary for the triumph of evil is that good men do nothing." -Edmund Burke (1729-1797)
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#12 of 12 Old 09-18-2009, 06:10 PM
 
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I'm so sorry it was horrible. My son is a very difficult stick. You did get the blood, right?

In case this needs repeated (I so hope not)--things I've learned to make a hard stick child a little easier:

--have her well hydrated before

--we stopped EMLA creams. It so helps with pain but it makes it much harder to get a vein...they shrink and flatten the veins which makes them more likely to roll and harder to access. Rats. I wish I would have seen this post before.

--Hold her in your lap and put your arms around her so she is as still as possible. Moving makes it slower obviously. Basically, stress makes it harder to get a vein so the faster the better and the lack of movement means faster.

--An NICU nurse should have been able to do this easily. I'd say the EMLA cream was the issue rather than her. But even better than NICU are pediatric ER people in my experience with my son. But either should be good. If you ever need an IV in this child insist on pediatric ER if you are in a place that has that (say hospitalized).

Let her play this out if she needs to--giving "shots" or blood draws on you and dolls in play. This seems to be most useful in helping my kiddo work through medical traumas.

Rachelle, mommy to 8 year old boys! 

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