The Fearful Child - Reducing Distress During Blood Collection
Pediatric Blood Collection
When it comes to pediatric patients undergoing venipuncture, it should be
every phlebotomist's top goal to reduce these children's fear, pain, and distress. Almost all children have a
natural fear of needles, but studies show that age is a significant factor in how they behave, their level of
distress, fear, and perception of pain.
Calming The Fearful Child...
It should come as no surprise that the use of physical restraint,
such as the child being placed on the parent's lap and tightly held down, will often add fuel to the fire!
Forceful restraint only increases the child's negative response and psychological suffering. However, there
are certain techniques that make the process easier. One is working calmly as a team, and proceeding at a
steady pace as quickly as possible. See 1 year old Jessica's blood draw that goes over quite well despite of
Watch this short phlebotomy video clip!
Helping a Child That's Scared
When a child's level of distress in anticipation of the venipuncture procedure is on the rise, it can be a
rather difficult task for the phlebotomist and parent to make the blood collection process go over smoothly.
Physically restraining a fearful child during the venipuncture procedure is in no way an ideal situation and
could be a disaster in the making! Rather, when dealing with a fearful child, it is best to try to control
fearful rejection and manage defensive behavior through parental coaching, distraction, and positive
Distraction during painful procedures were proven to serve as an effective means of intervention. Therefore, a
considerate phlebotomist will proceed by incorporating gentle touch and speaking in a soft voice while
coaching, distracting, and comforting the upset child. Toys and sounds can also be effective and practical
means to reduce a child's fear, and this, in turn, will also ease the parent's distress. Parents should also be
encouraged to participate in the preparation of the child in a meaningful manner. It has a positive impact on
the child if the parent remains cool, calm, and collected, uses encouragement, positive reinforcement, and
appropriate distraction techniques. The parent's location, i.e. where the parent is in the room in relation to
the child, can also make a significant difference when it comes to gaining the child's trust and cooperation.
Interestingly, although the above mentioned is a very simple approach to greatly reduce a child's distress, and
the parent's and phlebotomist's stress during venipuncture, it is not always routinely used everywhere there is
blood to be drawn! If you are among those phlebotomists who want to grow personally and professionally, and
lean how to better handle such and other challenges related drawing blood from children and using distraction
to reduce reported pain, fear, and behavioral distress in children and adolescents"visit NBCI PubMed
A Tip From the Pros:
Kids aren't as afraid of "mosquito bites" as they are of needles. Winged
collection sets look a lot like a giant mosquito drinking cherry Kool Aid. Most kids do geat if they can
relate to experience to something they understand. -- Heather Bridges
Never tell a pediatric patient that the stick will not hurt. Be honest,
and when the child does feel the stick it won't come as a shock. This way they handle the procedure a lot
better. -- Anonymous