Challenges of IV starts in the Pediatric Population

 

The Pediatric population provides special challenges during stressful procedures, such as IV sticks. This article will provide tips to alleviate fear and anxiety when starting IV's. We can help alleviate stress by being creative and compassionate.

 

One of the biggest challenges we face as pediatric registered nurses is how to alleviate the fear and anxiety associated with getting an intravenous catheter or IV. As a pediatric nurse for over a decade, this RN has been witness to many different reactions when it comes to needle sticks. There is kicking, screaming, hiding in the bathroom, and the one that is truly heartbreaking is the genuine fear in the faces of our sweet little patients that we treat. The good news is that there are many options available to us as caregivers to help our patients get the treatment they need, while alleviating the fear and anxiety that may go along with it. Some of these options include, but are certainly not limited to, the use of topical lidocaine and involving your child life specialist for distraction.

 

Ask any pediatric patient and they will tell you that topical lidocaine was their best friend during their hospital admission. Topical lidocaine is a three percent lidocaine cream that is used for anesthetic purposes to numb the skin. If you are not familiar with this medication, get familiar! Contact your hospital pharmacist and they will be able to provide specific side effects, absorption rates, along with precautions. When placed approximately one hour prior to the IV insertion, the skin becomes numb due to the properties of the lidocaine, and the child will not feel the “poke.”

We all know as healthcare professionals that things may happen without warning. You may find that you do not have that one-hour window to wait. In those cases, there is a fast-acting topical lidocaine that makes the skin numb in about half the time, approximately twenty to thirty minutes. Children that require chronic transfusions or repeated IV therapy will especially benefit from this medication because over time they learn that they can really trust that it will work, which will make subsequent visits less stressful.

 

The Child Life Specialist is another very helpful tool to have at the bedside during an IV insertion. Child Life Specialists are pediatric healthcare professionals who work in conjunction with the patients, their families, and the nurses during the child’s hospital stay. They are a great resource and should be utilized prior to any invasive or stressful procedure. The primary role of the Child Llife Specialist is to alleviate fear and anxiety in our patients when they come for treatment by utilizing age appropriate distractions and coping mechanisms. Who better to have at your side during an IV insertion! These Child Life Specialists will do anything in their power to help a child during a stressful situation. “I Spy” is a favorite, along with bubble blowing, and singing.

 

In summary, there are many options available to us as pediatric nurses to alleviate the fear and anxiety associated with hospital stays and “sticks.” Every child and situation is different and will provide their own set of challenges. It is up to us as healthcare professionals to be creative and compassionate advocates for our patients during their hospital stay. The pediatric population will present different and complex challenges due to their young age, inexperience and inability to reason at times.