Some of the most common healthcare experiences a person will have include blood draws from a vein (venipuncture) or from a fingerstick and injections, such as vaccines. Unfortunately, many people experience uncertainty, fear and anxiety when having blood drawn for lab tests. The process can be especially stressful for children and their parents.
A recent survey of 128 phlebotomists (people trained to draw blood), published in The Journal of Applied Laboratory Medicine (JALM), was conducted to identify and share techniques used by phlebotomists to reduce anxiety in young patients. The survey looked at current practices and training programs for laboratory professionals that aim to improve a child’s experience when having blood drawn. The survey data provided information about the specific challenges phlebotomists face when drawing blood from children and identified new focus areas for phlebotomy professional training programs that would improve pediatric comfort and support.
Phlebotomists that participated in the JALM survey identified patient (68%) and parental (63%) stress and anxiety as the most frequently occurring challenges they face when drawing blood from children. These were followed distantly by other concerns, such as positioning the patient (3%) or technical issues like finding a suitable vein (2%).
The JALM survey also asked phlebotomists to identify the different strategies they use to reduce a child's stress during blood draws. The most frequently used techniques included using words of explanation and comfort (70%), followed by positioning options (67%), and distractions—like bubbles, games, small toys, or tablet computers (43%). Phlebotomists also reported that they called on child life specialists to help comfort children (18%) and offered drug-free remedies such as “Buzzy,” a bee-shaped pain-reducing electronic numbing device, or topical anesthetics for children under the age of two (20%).
In a podcast about the JALM survey, lead author Julie Piazza from University of Michigan Medicine said needle sticks are the most talked-about healthcare experience in terms of pain for children—even more so than post-operative pain. Using comforting techniques can not only improve a pediatric patient’s experience, these techniques could also prevent the formation of a life-long fear of needles that could make an adult patient reluctant to get the laboratory tests and healthcare they need.
"Performing a pediatric blood draw or venipuncture is not just about technique," wrote the authors. "Aspects of this interaction with the child can and have been demonstrated to affect the success of the blood draw and influence future experiences of the pediatric patient and family."
In addition to a phlebotomist's techniques, a parent or caregiver can influence a child’s blood drawing experience. Lab Tests Online has several resources for parents who would like to help reduce the stress and anxiety their child may feel during blood draw procedures. Here are a few of the strategies:
Determine if your child wants to participate: Does your child want to watch the blood draw, or would they rather look away? If they want to look away, find ways to distract them from the needle stick—perhaps with a favorite book or song.
Rehearse the blood draw at home: Walking your child through the procedure could help them feel less stressed and more in control when it happens.
Prepare for the needle stick: Let your child know that the needle will hurt a little bit, but that the pain will not last very long.
Remain present: Stay with your child during the blood draw to provide physical comfort, distraction, and assistance.
Count to three and blow the feeling away: This is a useful technique to make a blood draw easier for your child and for the phlebotomist. Counting and exhaling slowly gives your child more control over the situation and keeps their veins full and loose. It also provides the phlebotomist with a good "cue" for inserting the needle.
Know what kind of blood draw to expect: Blood draws can be more than just a fingerstick. It may be necessary to draw the sample from a vein. Let your child know that there are different methods for drawing blood and ask your healthcare practitioner ahead of time which method will be used.
Additional information about this topic can be found on the LTOAU
website under the Coping with discomfort and anxiety
section including a video from the Melbourne Children’s hospital at https://www.rch.org.au/be-positive/