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It is well known that the ability to remain calm under pressure is essential for nurses, particularly pediatric nurses, who require additional patience when caring for children. In addition to meeting patients’ physical needs, pediatric nurses must also support parents and help children remain emotionally stable during medical procedures such as venipuncture, which can be particularly painful for children.
Children often experience anxiety due to fear of the unknown. When nurses and parents explain procedures using child-friendly language, children are more likely to understand and accept what is happening, thereby reducing emotional distress.
While parents’ questions are an important way to protect their children, excessive questioning may unintentionally increase anxiety. Children may sense their parents’ fear or distrust, which can heighten their own stress. Therefore, nurses play a crucial role in providing psychological support to both parents and children, helping them understand that venipuncture is a painful but necessary medical procedure.
Venipuncture in children is often challenging due to small veins, limited cooperation, and movement caused by fear and pain. Fortunately, technologies such as venous illumination systems can assist nurses in quickly locating veins while also distracting children, making the procedure more efficient and less stressful.
Patient identification
Use only when the wrist strap or foot strap is attached to the patient;Do not use bed numbers or wristbands attached to beds or cribs.If a parent or legal guardian is present, ask them if the child's name matches the name on the venipuncture or blood draw sheet.The guardian was asked to check whether the name, date of birth and hospital or file number on the test sheet matched with the person. After multiple verifications, it was confirmed that the blood was collected correctly before the operation of blood collection began.
Venepuncture
Venipuncture is the preferred method for blood collection of full-term neonates:
- Equipment and supplies for paediatric patients.Use winged steel needles, preferably gauge 23 or 23, with an extended tube (butterfly): avoid measuring values greater than or equal to 25, as this may be associated with an increased risk of hemolysis;Butterflies using vacuum tubes with syringes or adapters;Butterflies can provide easier access and movement, but the movement of the connected syringe can make drawing blood difficult.
- Use 1-5 ml syringes for infants according to collection needs;the vacuum created by suction with a mismatched syringe often collapses the vein.Harm to babies.
- When vacuum tube is used, the vacuum tube with small air concentration (1ml or 5ml) and low vacuum degree should be selected for infants;this helps avoid vein collapse and may reduce hemolysis.Reduce harm to babies.
- Use safety equipment such as needle caps when conditions permit.
Preparation
they are willing to help with the baby.If parents are willing to cooperate, the nurse informs the parents how to hold the child and where to light the lamp.If the parents themselves fear these procedures, it is advisable to seek help from other phlebotomists because of the baby's special nature.Do a venipuncture until you're sure someone can help stabilize the baby.
Way to keep kids in place:
1. One phlebotomist prepares the blood drawing while another phlebotomist or parent immobilizes the child.
2. Ask two adults to stand on opposite sides of the examination table.
3. Reach one hand across the table so the child lies on his back with the child's head over the outstretched hand.
4. Hold your child and calm him down.
5. Ask parents to tighten and relax their children's wrists rhythmically to ensure adequate blood flow.
6. Undress the child as little as possible. If the child is an infant, wrap the infant in a blanket and be held by a parent or caregiver with only the end of the venipunctures exposed.
7. Cover the puncture site with a warm cloth to help dilate the blood vessels.
8. Use a vein detector to find the most suitable vein to attract the child's attention and find the most suitable vein for the puncture.
Drawing blood
1. Phlebotomists should always pay attention to hand hygiene, patient identification, appropriate vein location, skin disinfection, etc.
2. Once the infant or child is, immobilize, puncture the skin in the distal vein (i.e. away from the vein) 3-5 mm;this allows good access without squeezing the vein.
3. If the needle goes into a vein rather than into a vein, withdraw the needle slightly, but not completely, and allow the needle to enter the blood vessel.
4. Steady and uniform blood drawing.
Pediatric Venipuncture by Age Group
Infancy (birth to 1 year old)
Children in this age group are generally not conscious, but the fear of venipuncture is not so strong.Babies at this stage are still very young, and most parents are new parents, so nurses also need to explain to parents and give them a psychological expectation.Communicate with them in advance about venipunctures, uses, etc.Ask your parents about feeding times and try to avoid venipuncture right after feeding.Tell parents you can use some.Songs, nursery rhymes, etc. distract children.If pedal IV is chosen for infants, parents immobilize the infants feet beforehand.
Children (1-3 years old)
Children at this stage are already aware of what venipuncture is, and most of them are very resistant to it.Some are just learning to walk. Some are just learning to run.There was a tremendous increase in mobility, and they either cried or said "no" to the venipuncture.
So for children at this stage, nurses should ease their resistance in advance.Provide transitional items such as toys, etc. Distract them with games, TV shows, songs.Ask for parental assistance and praise after venipuncture.
Preschool (3-5 years old)
Preschoolers, obsessed with magical thinking, may fantasize about surgery and dread the procedure.Parents or nurses can try medical games, such as putting IV devices on teddy bears.Reward good behavior.Distract yourself with specific games and songs.
School Age (5-12 years old)
School-age children are more independent and are acquiring new skills.Body image is a problem for older children to explain procedures in simple terms.Let your child help set up devices or do small tasks.Provide privacy or have a parent present if the child needs it.
Youth (12-18 years old)
Teenagers vacillate between the need for independence and dependence on others for care.They're used to things like venipuncture.However, a small number of nurses are still afraid of the process, so nurses should maintain privacy and confidentiality.Teenagers may prefer their parents to be absent.Explain the program in adult language.Involve adolescents in nursing decisions.Consider body image when selecting vascular access devices and care.
Considering the age of your patient, it may be easier for you to perform venipuncture.
Why Make Patients Wait?
Try the Vein Finder and make every procedure easier!
Summary of skills:
1. Find a laboratory suitable for venipuncture or blood drawing of children.
2. Nurses should keep themselves, parents and children calm.
3. Invite colleagues or parents to anchor or distract the child.
4. Try to avoid talking about the fear of venipuncture in front of children.
5. In order to complete the venipuncture process smoothly, the nurse should tell the parents to fix the child.
6. Invite colleagues or parents to anchor or distract the child.
7. Praise your child's bravery after completing a venipuncture or blood drawing.
8. The nurse should inform the parents in advance of the location of the venipunctures.
9. Take different steps according to your child's age.
Make Every Patient Experience Smoother
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