Needles, Blood Draws, IVs, and Central Lines - Children and Teens with Cancer
There are many ways you can support your child in the clinic and the hospital because blood tests and intravenous medications are a part of cancer treatment life.
1. Stay calm yourself.
2. If your child is a "difficult poke", make sure they have drunk plenty of fluids beforehand, and that they are warm (veins are more difficult to find with dehydration or when the weather is cold).
3. Consider a comfort stuffed animal or doll.
4. Think about asking your child to look away when the blood is being drawn or the IV placed.
5. For young children, allow them to sit in your lap. For older children, hold their other hand. For preteens and teens, ask them if they'd prefer you waited outside.
6. Speak soothing words. Our daughter's first IVs were fairly traumatic and at the first hospital we went to, they didn't allow us to be present (not a Children's Hospital) and she required multiple pokes. Afterwards, we politely insisted, and we calmed her with words like, "You can do this." "You're doing great," and "God's with you."
7. Be friendly with the technicians, but if they are clearly struggling, ask for another nurse or phlebotomist. Sometimes they will send for the most expert pediatric nurse available.
8. If your child is a "difficult poke", get to know reliable veins that can help the technician or nurse draw the blood they need. Some veins fibrose after having pokes or IV's and these can be misleading and cause unnecessary sticks for regular blood draws. Most blood drawers appreciate it if a parent can direct them to a "good vein."
9. There are more anesthetic options available than ever before, but be aware that some of the anesthetics (like lidocaine, EMLA, Jtips) narrow blood vessels making it more difficult to draw blood or place IV's.
10. When undergoing a procedure, see whether an IV can be placed as your child is being induced with laughing gas. This not only eases a child's anxiety, but also reduces the pain of the IV placement.
11. For older children (often tweens and teens), a strong vagal response may mean that they become pale, clammy, and light-headed with pain. If a nurse is having trouble placing an IV or drawing blood, and your child looks pale and the veins look like they've disappeared, see if they can lie down on a table or gurney, and take a break before trying again. During this break, pray with your child, ask for a warming blanket, and raise their legs up (higher than their heart, if possible). These simple steps can work wonders.
There are many other helpful tidbits to learn about IV's, their need to be changed, and the special care of central lines. Some additional resources are listed below.