Blood tests and venepuncture factsheet
Introduction
When your child has a blood test, a doctor or nurse uses a needle to take a small amount of blood from their vein. This is called venepuncture.
Blood tests are sent to a lab for testing by a doctor called a pathologist. Pathologists test blood to look for:
- different diseases
- infections
- check levels of things like vitamins and hormones.
Some illnesses and conditions can only be checked by a blood test.
Before the test
Your child's doctor or nurse will explain why the test is needed and what it is checking for.
It is normal for children not to like needles. You can ask for special creams or other devices that reduce pain from the needle.
This cream can take about 30 minutes to work, so it can only be used if the blood test is not urgent. Creams and other devices for blood tests may not be available at your local clinic, so it's important to call ahead to check.
Parents and carers can stay with their children to support and distract them while blood is being taken.
Preparation
Research shows that distraction is the most helpful tool in supporting children to cope with procedures. Younger children understand and learn about the world through play, for example using a play medical kit to give teddy a blood test.
It is good to have a think about what you might take along with you to use for distraction and support during the procedure. Bubbles for blowing, your phone or tablet for playing favourite apps, a story or look and find book are all good options.
Allow your child to help with this decision. It is important to provide children with a sense of choice and control by providing real choices.
Think about what to tell your child and when to tell them. Honesty is very important, it will help children to process what is going to happen. However, the flip side is that too much information too early can be anxiety provoking.
Talk with your child about what is going to happen using the 5 W’s.
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 the hospital' (you can specify department or level)
What might happen and what do you have to do?
“We will wait and play with some toys and then go into a special room with a big comfortable chair where a person a person will take a tiny sample of your blood for the doctors."
“I will give you a hug and your job is to keep your arm very still.”
Who will be there?
“I will come with you and there will be a special nurse called a phlebotomist - that’s a funny name isn’t it."
During the test
On the way into the hospital it is helpful to remind your child where you are going and why.
“Remember today that you are going to have a blood test and you have a special job to keep your arm still.”
- You or your child will be asked to check the details on stickers that will be used to label the blood samples
- An elastic belt called a tourniquet is put around your child’s arm and is pulled tight to help show where a good vein is
- The skin over the vein is cleaned with a small alcohol swab
- A needle is put into the vein, and blood is taken quickly into several vials.
- Once the blood is collected, the needle is removed, and a cotton ball is pressed on top to stop the blood from flowing
Your child needs to sit still while their blood is being taken. A nurse may need to hold your child’s arm to keep the needle from moving or coming out. This is to keep your child safe and avoid having to retake blood.
A second sample might need to be taken if:
- a vein can't be found
- not enough blood was taken
- your child moves, and the needle comes out of the vein.
Veins can be challenging to find in small children and those who are very young or chubby, like babies and toddlers.
During the test try and remember to
- Inform the blood collector of the plan you have created for distraction, and discuss how your child may prefer to be positioned (for example sitting on your lap, koala hug, sitting in the chair).
- Settle the child into your chosen position, see Supporting your baby through painful procedures and Supporting your child during painful procedures
- Start using your chosen distraction.
- Continue to explain what is happening to your child (for example “now they are rubbing your hand with the cold wipe”).
- Try to focus them as much as possible on the distraction and remind them of their job.
Should I let my child watch the procedure?
Many children need to look at what is happening to feel in control.
Looking is ok, make sure the child is aware that looking and not looking are both options and either is ok.
Pain relief options
Research shows that children and young people’s experiences of procedural pain can affect their pain tolerance throughout their life. For this reason we promote the use of pain relief wherever possible.
For children over one-year-old:
- We recommend the use of what are called topical anaesthetics – EMLA, LMX4.
- You can purchase these at a chemist before your visit and apply them yourself, or you can ask for them to be used at SEALS (if you arrive prior to 3pm).
- They take between 20-40 minutes to work best.
- We tell children this is special magic cream which helps to numb their hand so they don’t feel very much of the blood test.
For children under one-year-old:
- We promote the use of breastfeeding or sucrose (a sweet sugar solution) while the procedure is happening.
After the procedure
There can be some soreness and bruising after the venepuncture, depending on how easy the vein was to find and whether there was any movement. This should go away quickly.
Praise
Praise your child for the things they did well at during the procedure (for example "I really liked the way you kept your arm so still").
Stay with your child until they are calm. Give your baby or infant a cuddle or a feed.
Review
Talk to your child about the things that 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").
