Practical tips when having a Painful or Unpleasant Procedure

Practical tips when having a Painful or Unpleasant Procedure

Before your child has a medical procedure that may involve needles or discomfort, such as giving blood, or taking medication, make a clear plan with your child and be ready to share it with your medical provider.

Sometimes people think that having a medical procedure means giving up control, but feeling empowered with a plan is an option, and it makes for a much better experience. When people young or old, know how to face a challenge, it is easier if you feel in control.

Below are a few tips to help you build a plan. With a ‘comfort plan’, your child will decide what they want to do, to be more comfortable, and how to minimise feeling pain from a medical needle procedure.  Remember to try out and learn the selected technique at home, before it is needed.

  • Distraction:
    You know how hard it can be to get your child’s attention when they are deeply focused on a TV programme, playing a game or on a smart phone. Use that same tool to direct their attention away from anxiety and pain. Let them chose what they want to do to distract themselves before and during the procedure. A few ideas include telling a story, reading a book, (Using an I Spy book like Where’s Wally?  This is a great book that keeps a child’s mind distracted as they are hunting for Wally), play a game on your phone or tablet device, use a spinner toy, sing a song and watching a funny video. You can also get your child to focus intently on something in the room. Find a picture, poster, or a sign on the wall. Concentrate on the details: If you and your child are looking at a painting, get them to count the number of flowers in the garden, cows in the field.  For older children: create as many new words as you can using the lettering on a sign. Distraction in general reduces pain by up to 50%.
  • Breathing: 
  • Have your child practice taking easy, slow deep breaths in and out. Breathe all the way down into your belly, making it rise. Take a big breath through your nose, and then blow out through your mouth. It calms them down and lowers their body’s reaction to pain. You can help them by breathing along with them. Blowing bubbles, balloons or pinwheels also can help slow their breathing and distract them from the procedure. Do this before, during and after the procedure.
  • Vibration: Most people don’t realise that pain is actually processed in our head. When our body feels a possible threat, it sends a warning along nerves to the brain.  But there are ways to stop the signal from reaching our brain. One way is to use vibration on the skin to create a traffic jam in the nervous system.  It’s the same idea when you rub a bumped knee or elbow. When we place a vibration tool on the arm or leg just above where the injection is given, it overloads the nervous system and changes the sensation and reduces the feeling of pain. (BUZZY 4 shots is a vibration tool)
  • Icepacks: Cold packs can help to decrease pain. The BUZZY 4 shots, has blue gel ice wings that are re-useable.
  • Holding / Hugging: If your child likes the idea of being held there are many ways you and your child can sit that makes them feel safe, still and comforted by your touch and closeness. Your touch and the comfort positioning change how the body processes pain signals. It can work for older kids, too. Sitting up, not lying down. Positions can be: – (1) Child sits in front of parent on the parent’s knee. (2) Child sits on parent’s knee facing parent – tummy to tummy. (3) Child sits on parent’s knee, child’s legs and body facing to the side.
  • Massage: There is plenty of research extolling the virtues of massage therapy in reducing anxiety, and it can also be highly effective in relaxing a child before and during a needle procedure. Giving a simple hand, neck or foot massage can help calm their nervous system response by easing both physical and emotional tension.
  • Tapping: Tapping is like acupuncture and acupressure but NO needles. Tapping can prove to be a very useful technique to help children deal with their fears, stress and anxieties and in physical relief for children having medical procedures. It has been clinically proven to reduce cortisol levels. These are a few of the tapping points: – (1) Tap at the beginning of the brow, just above and to the side of the nose. (2) Tap under the eye, on the cheekbone – on the bone under the eye. (3) Tap on the side of the hand, down from the little finger. When tapping use two fingertips and repeat the tap for approx. 5 mins or longer. Tapping is a gentle technique.

The tapping technique works the same as vibration and rubbing techniques.  Tap close to the painful site, between it and the brain.

  • Crossing arms: Crossing arms across the middle of your body can mix up the brain’s perception (confusing the brain) of pain signals and can help reduce the intensity of pain sensation.

 Numbing creams and sprays: Ask your child’s doctor about an anaesthetic numbing cream such as EMLA cream or the EMLA dermal patches or AMETOP GEL. They are used to numb the area of the skin before a medical needle procedure.

  • Cough: Research shows that coughing once before and once during the needle procedure can help some people feel less pain.
  • Squeezing: Before your child has a needle procedure, have them squeeze their hands together or around a stress ball; squeeze and hold for five seconds, then release. Repeat these 3 to 5 times. If this works well, you can also try tightening other parts of the body and then releasing. For example, close eyes tight and scrunch face for five seconds, then release. Start with the face and work down to the toes.
  • Music: Sing or listen to soft music. Have your child listen to their favourite music/band.
  • Comfort object: Take your child’s favourite doll or a stuffed animal to a medical procedure. The toy can have the same procedure done to them as your child is having. The toy gets an injection, sticking plaster etc. the same as the child. Take their comfort object, such as a blanket along. Familiar things often make a child feel more comfortable and less anxious.
  • Virtual Reality Technology: Virtual reality (VR) is an especially effective method for older children who aren’t as easily distracted by books or videos. Children wear VR headsets and enjoy an entertaining, immersive experience that can make them feel transported to another space entirely.  Because VR integrates visual, auditory, tactile and even olfactory sensory distractions, people have fewer ‘sensory resources’ to dedicate to the sensation of pain and may not feel it as intensely, if at all.
  • Role play: Role play using a toy doctor set. They could use it to practice giving you a shot or using their toys to practice on. In play you can help to explain the procedure. Reading age relevant picture books on having a needle procedure can also be helpful.
  • Positive Role Model: A child can benefit from seeing a parent or someone they know, who copes well with injections have one in real life.
  • Reward their courage: Discuss with your child what reward or incentive they would like after a needle procedure. Write them on paper and put them in a box. Make it a lucky dip. E.g. visit to the park, baking together, playing a board game, a later bed time, or a favourite snack. Thinking about picking a reward may help distract your child.
  • General anaesthetic: If your child is having a general anaesthetic and they are feeling very anxious, consult with the paediatric rheumatologist or surgeon, to see if it is possible for your child to be prescribed a sedative before the procedure.

Note for the Parents: –

  • Be honest, and reassuring to your child.
  • How you, the parent/caregiver behave, react and respond has a big effect on how your child will experience pain.
  • Be on time for the appointment and do not rush.
  • Make sure your child is warm, relaxed and hydrated. For a blood test being hydrated makes it easier to draw blood, because it puts more fluid in the veins.
  • Parents should stay cool, calm and collected. Smile, your attitude is more important than you may realise.
  • Have your child’s ‘comfort plan’ ready for the needle procedure.
  • Timing is important. This will depend on the age of the child. A little advance warning is a good thing. You know your child better than anyone, so use your instinct as to how much notice you give them.
  • Talk about their fears, if they have any. Help them understand the reasons why they need a medical procedure.
  • Be sure to let the doctor or nurse know that you and your child have talked about choices and share your plan.
  • Provide lots of positive praise
  • Be ready with a reward