How to Prepare Kids for Lab Work, Medical Procedures?

Hopefully you get this quickly lol. But I'm taking all three kids to get their blood drawn on suspicion of elevated lead levels. I do NOT want to risk what happened w/ shots when DD freaked and jumped and the needle came out and she got all scratched up from her flailing. She has to sit still. I tried to discuss how she can keep calm today and she started freaking out already. Once she starts freaking the other two will freak and where they may have cried before I'm going to end up with pandemonium at the lab. Sooooo...how to get these kids ready so theydon't start jumping and end up with ruptured veins as a result?

BF Guru

Dear BF,
What an image!

1. Is there any way you can have someone else accompany you? It is best if you can take each child, one at a time, into the room to have blood drawn. If they have to watch each other, it adds to the hysteria and you are much more likely to get the kind of scene you're describing.

2. Of course, each child will need you to hold him or her during the procedure, which has been shown to reduce the pain the child feels as well as their panic. I want to differentiate your holding her for comfort from holding her down for the blood draw. Parents should not hold kids down for medical procedures; it destroys the child's trust in the parent. If she is so frightened she needs to be held down, I would bring her back alone another day, after you've read a lot of books and practiced a lot with a doctor kit. If she still needs to be held down then, it's the job of the medical staff. The parent's job is to comfort the child during the procedure, not to restrain.

3. Give each child tylenol an hour before a shot, which works very well to minimize the pain. I am also a big fan of numbing creams. I'm a psychologist,not a medical doctor, so I do advise you to check with your own doctor. But I can tell you as the mom of a needle-phobic child that I have put a small amount of over the counter numbing cream on my daughter's arm an hour prior to a shot and she didn't feel a thing. There is prescription-only numbing cream, but some kinds are available over the counter.

4. Research shows that kids do better with medical procedures if they are distracted. This is especially true for a blood draw, because watching the tube fill up with blood tends to make humans nervous (although I have heard of kids who were fascinated once everything was explained to them). I suggest telling your kids that you want them to pick something to pay attention to while at the lab. Give them a choice of one or more distractions: a lolly pop, blowing bubbles, a squeezey ball, having you sing them a song, listening to a story on headphones, having you read to them, etc. (There was one study that showed lolly pops greatly reduced distress during shots, so I would go for the most appetizing lollies you can find, in addition to whatever else they choose!)

5. You should know that anxiety makes pain worse. All kids do better if they are prepared, but the trick is for that preparation to reduce kids' anxiety, not increase it, LOL! Usually the best way is to read some books about doctor visits and talk about how they keep us healthy.There is always a page about the shot, and sometimes about the blood draw, but you can minimize the focus on that. Explain that sometimes paint dust in an old house gets into our body and isn't good for us,and looking at our blood will help the doctors evaluate that and keep them healthy.

Tell your kids that the blood draw will be an ouchie, but the numbing cream will make it a small ouchie, which will stop hurting very quickly. (Let them put a dab of numbing cream on while you are preparing them so they can get used to the numb feeling.) Tell them that you have had blood drawn and it did hurt but only for a minute and you were just fine. Tell them it's ok to cry but they need to sit very still and you will hold them and they can squeeze your hand as hard as they need to. Remind them that they will have their lolly pop, squeeze ball, bubbles, story tape, Blankie, or whatever.

6. Practice with each child, using their bubbles, lolly pop, book, etc. (minus the blood draw, of course!) You definitely want to instruct them to sit very still on your lap and not to look at their arm. (You might give some thought to how to hold a book to block their view.) Of course, in the moment at the lab, if they need to cry, let them cry. But leading up to it and even during the blood draw, their anxiety will be much reduced with distraction. And your calm singing and secure holding really does help to keep them calmer.

7. Research shows that kids do better with medical procedures if they feel a bit more in control. That means giving them any choices you can. For instance, let them put on the numbing cream themselves. Let them choose the squeeze ball. Let them decide which arm. Let them each pick a band aid to bring. (Most kids like it best if mom puts on the band aid, rather than a stranger.)

8. Call the lab in advance and specify that you would like a lab tech who is experienced in working with kids. The attitude of the nurse or lab tech can either make a child comfortable or scared. If you need to change the time of the appointment so the right staffer is on duty, it's worth it. This may be just a routine visit, but to your kids it's a big deal and could make the difference in whether they run screaming from doctors for the rest of their childhoods.

9. Warmth makes veins come to the surface. Dress the kids in long sleeves, and if it's cool, wear jackets.

10. Stay calm yourself!

11. Definitely go out for a treat right afterwards, like ice cream. Amazing how it takes the sting out of a medical procedure. Don't reward them for "being good" or not crying, since it is fine to cry when they hurt. You don't want them to stuff their feelings. In fact, have each one tell his or her story, and if that makes them shed a tear or two, that's great to get those feelings out so they don't stuff them. Then make a toast to their bravery: "Yay, we did it, let's celebrate!"

12. Buy a cheap doctor kit for your kids to play with. Any residual trauma will be played out by their drawing blood from the Teddy Bear over and over.

Good Luck!

Thank you Dr. Laura, once again.
It was too late for numbing creme. I did get them tylenol and I had printed out a bunch of photos to give to daddy and the doctor for their desks (doctor asked for some for her bulletin board). So we distracted her with sorting them. Daddy delivered huge ring pops and stayed with the big kids while the baby and I went in. The poor thing had tiny veins that promptly blew out but the screaming came from pinning him down as they set up the station for the other arm instead. Of course big sister began to freak there so we let her other brother go first who barely whimpered -- thank you lolli. She however did lots of "I'm scared! No I'm not ready! Please not yet!"

However one can only wait so long before it's time to get the show on the road and she would have never been ready. So daddy held her as still as he could and they went as fast as they could knowing how scared she was (I informed them when in with the baby) then she was finished demanding to see the doctor to give her the photos. Doctor came out and said "your mom made me do it!" and everyone laughed and got hugs and kisses from their favorite ped, who informed them they must now go home and brush their teeth. It was rather traumatic for mom with the baby's vein blowing,but all in all as terrified as she is (and I can't blame her I was the same way) things went well.

The downfall, they wouldn't perform for me as we taught them to say "phlebotamist" and they refused to say it for the actual phlebotamist. Oh well.

Thanks again!
BF Guru

Dear BF,
The photos were a stroke of genius, and thank goodness for lollies! Your kids now know a word most adults don't know, and all in all it sounds like everything went well. What a relief!


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