How to take blood for paediatric patients?!?!

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the_historian

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I am currently rotating in paediatrics and I’m struggling mightily in performing blood taking/ venepuncture/ iv access on paediatric patient, esp. neonate/ infant/ child who struggles greatly. Any tips? Many thanks.

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Ask a nurse to help

Apparently in my local setting the nurse would not assist in blood taking. After two to three failed attempts I have to find senior MO to take over but I do not wish to keep on bothering them.
 
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These patients can be notoriously difficult, and subjecting them to repeated attempts at venipuncture is not benign. Your hospital has an attempt limit and an escalation pathway for a reason. The best way to improve is to continue to take your allotted attempts and to ask more skilled individuals to watch their attempt (or if they're gracious to watch yours and coach you)
 
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Most of the time for CBC or CMP we do a little puncture on the heel or finger, then squeeze and scoop drops of blood into tubes with caps until desired amount is reached.

IV - very difficult and usually two people hold a swaddled baby down, an experienced nurse puts in a 22G.
 
Get a flashlight, peer through their translucent skin...
 
It’s difficult due to their anatomy and hard to give advice without seeing you do it. Ask the seniors you’re working with for tips. In general older kids or teens will be easier.
 
Make sure to anchor the vein down and tie a tight enough tourniquet. One you feel the vein make sure you feel it while you anchor in case it moved. Lock your eyes on exactly where you want to poke and then trust you did.
 
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