Preparing your child for medical procedures

Honesty is very important but too much information can make a child nervous.

Try to explain the procedure in simple steps and allow time for your child to ask questions. Use language they will understand without describing the intervention in detail.

Avoid saying things like: ” ..a really long needle ..”.

The hospital Child Life Therapists have props, books and resources that can be used to explain complex procedures and might be useful if your child is very inquisitive or requires repeated explanations. They can demonstrate some procedures in a pre-arranged visit if your child is especially anxious.

• Read the Supporting your child through painful procedures Factsheet
• If your child is young, the Medical play Factsheet might help

Too much information provided too early, or in too much detail can provoke anxiety, so think about the best time to tell your child their test or procedure is due.

In general, tell your child on the day of the procedure rather than at night when they might dwell on it and be unable to sleep. Allowing time for your child to process the information is also important, otherwise they may experience mild shock at arriving at the appointment without prior knowledge of what will happen. You know and understand your child best, so think about their likely reactions and accommodate them as best you can.

If the test is a recurrent one and anxiety has increased over time, try splicing the hospital visit with other activities so there’s a range of things to think about.

Here’s an example:

 “This afternoon, I’ll pick you up from school because we have your blood test before swimming so can you go and pack your swimmers please? …”

Decide who will accompany your child to the appointment. If one parent or carer experiences anxiety in hospital settings, it might be better for the other parent to take the lead.

If the procedure is time consuming or involves several steps or waiting, think about which parent or carer can provide the best distraction and entertainment.

For repeat tests and procedures, consider asking a grandparent to play a role as the child may like to ‘show’ them around and demonstrate how ‘brave’ they can be.
 

Why the test needs to happen – “the doctors need to have a look at your blood”

When the procedure will occur – “We are going to go tomorrow”

Where it will happen – “at our doctor’s office”

What might happen – “we’ll wait and play with and then go into a room with a special chair where a person  will take a sample of your blood for the doctors to look at …”

What do you have to do … “your job is to keep your arm very still.”

Who will be there … “I will come with you and there will be a person called a blood collector – that’s a funny sounding job isn’t it?”

It’s important to remember that pain is a very individual experience so never tell children “it won’t hurt”.
 

Younger children understand and learn about the world through play.

It can be helpful for them to act out what is going to happen, for example by using a play medical kit to give teddy a blood test.

This strategy is particularly helpful for kids who need repeated procedures.

Research tells us that distraction a very helpful tool in getting children to cope with procedures. Think about what you might use for distraction and support during the procedure. Bubbles for blowing, your phone or tablet for playing a favourite app, a story or a Look and Find book are suggestions.

Allow your child to help make the decision about what can be used to distraction this gives them a sense of choice and control by providing real choices.
 

Research shows that children and young people’s experiences of procedural pain can affect their pain tolerance throughout their life. For this reason the Sydney Children’s Hospitals Network promotes the use of pain relief wherever possible.

For children over one who are having blood tests it can be helpful to use medications called topical anaesthetics such as EMLA, LMX4. These are available from chemists and can be applied before the procedure.

We tell children this is “magic cream” which helps to numb their hand so they don’t feel as much pain from the blood test or injections. Alternatively, small icepacks cna be beneficial for injections.

You might prefer to use Buzzy, a little device that vibrates and interrupts the pathway that communicates pain to the brain. Buzzys are available at the hospitals for loan to see if they assist your child.

For children under one we recommend the use of breastfeeding or sucrose (a sweet sugar solution) while the procedure is happening.

On the way into the blood test or injection it is usually helpful to remind your child where you are going and why:

“Remember today that you are going to have a blood test at the doctors, and you have a special job to keep your arm still”.

Inform the blood collector or doctor of the plan you have created for distraction, and discuss how you prefer your child to be positioned, for example, sitting on your lap, in a koala hug, or on a chair.

Have a look at this poster for suggestions about positioning.

• Settle child into your chosen position
• Start using your chosen distraction.
• Continue to explain what is happening to your child: “now they are rubbing your arm with the cold wipe” etc.
• Focus them as much as possible on the distraction, remind them of their job: “remember your job is to keep your arm still …”.

Some children need to look at what is happening to feel in control and to make sense of the experience.

Make sure you child is aware that its their choice to watch or not and either option is fine.
 

• Praise your child for the things they did well at during the procedure: “I really liked the way you kept your arm so still”.
• Stay with your child until they are calm. Give your baby or infant may like a cuddle or a feed.
• Talk to your child about the things they did that were helpful.
• Even if your child was very upset, find a positive thing to mention, as this can help promote a sense of achievement.

For example: ‘You did really well with your deep breathing!” or “You kept your arm very still, well done”.