Preparation is Key for Pediatric Blood Draws

Each day, phlebotomists are tasked with putting patients at ease during a blood draw. This can be especially challenging when it comes to pediatric patients.  

Sue McAnany, MT, phlebotomy education coordinator at URMC, says her trainees are instructed to give special care to younger patients and involve the parents and caregivers to make the draw go as smoothly as possible.

McAnany oversees the 12-week training for all newly hired phlebotomists at URMC. During this time, the employees must perform a minimum of 50 venipunctures (and members of the inpatient vascular access team must perform twice that many). Within the first few weeks of training, phlebotomists perform draws on pediatric patients of different ages. 

“It’s very important that they feel comfortable with the procedure on adults before we move on to pediatrics,” she said.

The University of Rochester Medical Center and Golisano Children’s Hospital have adapted concepts from the Poke and Procedure Program  which was originally developed at the University of Michigan Health System. This plan outlines specific ways parents and caregivers can be helpful during pediatric blood draws – asking them to fill out a form describing their child’s experiences with needle-stick procedures and what type of distraction techniques or comfort positions they prefer.  

Communication is vitally important in each step of the process, explains McAnany. When the patient arrives for treatment, it’s important for the phlebotomist performing the draw to clearly delegate responsibility to the adults present. This helps minimize potential anxiety for the child.

“If you have more than one person trying to hold the patient, it’s very overwhelming for the child to have everybody talking at the same time,” she said. “One person in the room should be the speaker.”
Sometimes, if there is just one phlebotomist on site and a caregiver is not present in the room, he or she must hold the patient while making the draw.

Most lab locations that frequently have pediatric patients are stocked with photos, bubbles, and other distraction tools that can help divert the child’s attention before or during the needle stick. These tools often include a “Buzzy,” which is a small cold pack shaped like a bumblebee that can vibrate and help numb the area. No matter what tools a phlebotomist chooses, communication is an important part of any draw. 

“For a patient who’s never had blood drawn, you need to explain what’s going to happen (saying, It’s going to be a little bit of a pinch),” said McAnany. “If you distract them just by asking the patient about themselves, they won’t concentrate on the blood draw.”

Each patient is different when it comes to pain or discomfort, and having your blood drawn differs from getting a shot or vaccine because it is drawing the specimen out of the body rather than injecting something into the body. Still, some of the bravest patients often shed tears during or after the “pinch,” but phlebotomists are trained to give words of encouragement and praise.
 
“I always tell them that it’s OK to cry, but really try to hold still,” said McAnany. “You really have to get a good rapport with them and be soft-spoken.”

At the end of the day, she says the quality of these interactions will shape a patient’s overall experience. While needle-sticks can be challenging for patients at any age, following the right protocol and tuning in to the patient’s needs is absolutely essential.

Establishing a good relationship with a patient often results in them asking for a certain phlebotomist for future visits, even when it means waiting longer.

“Even some adults follow the tech from site to site just because they’ve had a good experience,” said McAnany.

Read more on this topic: CAP Today: Helping phlebotomists ease pediatric patient anxiety

Bethany Bushen | 8/16/2017

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