Many children with disabilities need to get their blood drawn regularly for lab work. While it’s never a fun task, it can be downright impossible for some kids. With the help of Undivided parents and Rachel Delano, MSW, LCSW, CCLS III, child life specialist at Baystate Children’s Hospital in Massachusetts, we’ve put together tips that will help parents and kids have a less stressful experience when getting their blood drawn.
While the following tips are specific to blood draws, these strategies can be applied to any necessary maintenance appointments, such as doctor visits, vaccines, haircuts, and nail trims.
Ask to make an appointment with a pediatric phlebotomist, as they can be more flexible and cooperative about your child needing more time and guidance than at general locations. If you are going through Labcorp, you can select locations that have a pediatric phlebotomist. Many pediatricians can also conduct blood draws in their office.
Call ahead of time. Rachel Delano tells us that it can be helpful to inform your provider of the challenges you anticipate. “This can also allow them to schedule you with a provider who is more comfortable working with a child who struggles in the medical setting,” she adds.
Ask about using pharmacological aids. Numbing medication can be applied at home prior to leaving for the blood draw. Delano explains, “You place the cream on your child’s forearm and cover it with the provider sticker so that when the provider finds the best vein, the area is numb.” She says you can also ask if the office has freeze spray, which numbs the skin instantly but is very cold (some children don’t like this sensation). “You can also ask for an anxiolytic such as Ativan. It takes 30 to 45 minutes to work but can help with anxiety around the procedure to take the edge off,” Delano adds.
Have an honest discussion and offer choices. Delano says that “children benefit from honest steps, even when they are resistant or will not like what’s going to happen.” If your child benefits from talking about the plan ahead of time, she says, it’s important to discuss the steps and allow the child to make choices when possible. “If you anticipate that your child will be resistant, tell them the day before and say, ‘We can go get bloodwork done today or we can go tomorrow.’ Then you’re able to remind your child about their choice, and they feel more in control.” Other choices you can offer are sitting by themselves or in your lap, and watching the procedure or looking away.
Find a coping strategy. Delano says this can include noise-canceling headphones, listening to music, watching a video, or using a sensory fidget. Ask your child, “Would you like to hold my hand?” or “Would you like it if we count down until it’s over?”
Read a story and watch videos. Social Stories can help present upcoming events in ways that are easy to understand. Make a story of the what, why, when, where, who, and how of getting blood drawn. You can use a template and fill it in with your own pictures, which is often helpful for kids.
There are many videos on YouTube showing kids getting their blood drawn without crying or resisting. Showing your child someone their age who is calmly going through the same activity can be a good example that everything will be okay. As you’re watching the video, you can pause in different spots and describe what’s happening and how your child might feel. You can mention, “It won’t hurt as much if you are relaxed and don’t move.” Watch as many times as needed until your child feels more at ease. Here are some examples:
Story: I am going to have a blood draw!
Story: Getting blood drawn
Story: Getting a blood test
Video: Blood draw demo
Video: Micah gets his blood drawn
Video: Brooke gets her blood drawn
Video: Understanding blood tests
Schedule a visit to the doctor’s office or the location where you’ll be doing the blood draw to explain the events and get accustomed to the environment. If you can, meet with the phlebotomist so your child will recognize the person on the day of the blood draw. Explain that on this first trip, no blood will be drawn and it is just a visit to see the office and then go home.
Explain to your child that they have the right to consent. Giving their consent allows children to feel a sense of readiness and control. This process will take time, and it might mean a few failed appointments. You can explain to your child that their body belongs to them and they have the option to say no.
Count down to your child’s appointment and make it seem exciting. Let them know it is in three days, two days, etc. By presenting it as something to look forward to and creating a positive attitude around the event, you can help ease their trepidation.
Plan an activity or a reward that your child can look forward to if they are successful with getting their blood drawn. This way, you’re combining a fun activity with the blood draw.
Allow your child to consent to the blood draw. Parents can sometimes be encouraged by medical staff to restrain their child during a blood draw to ensure cooperation and a steady arm. The phlebotomist may ask that you hold your child’s arms or lock their legs between yours, but restraint can escalate the behavior and may cause more harm than good. If you are asked this, you can explain that you would prefer that your child give consent and that no blood will be drawn until they give permission.
You can also state that you would like to hold your child in your lap. Delano says that if you are advocating for this, it is very important that you hold your child firmly so that no one is injured. “When you provide a tight embrace, you can softly speak into your child’s ear that you are there to keep them safe and explain that the provider is there to help them,” Delano says.
If your child reacts negatively while in the chair, such as flinching or screaming, ask your child if they can be brave, but give them the option to say no. If the final answer is no, leave the appointment and reschedule for a different day so you can try again. This may happen a few times before your child consents. For many children, having a sense of control over the process will greatly reduce their fear and anxiety, which will increase their ability to be brave.
Distract your child. Getting your child to focus on you rather than the phlebotomist can be difficult. You can watch this video, which explains how you can put methods of distraction into action.
Discuss how the appointment went. Having a discussion with your child about how the appointment went and how your child felt can help encourage calm, patient behavior for future blood draws. If they decide to say no and leave without getting their blood drawn, this can allow you to understand their fear and hesitancy. If they were able to get their blood drawn, discussing the events and saying something like ‘Next time won’t be as scary’ can reinforce how well they did and add positivity surrounding the event.
Reward your child. After your child successfully completes the blood draw, reward them with verbal affirmations and the activity or item you talked about. This can include letting them hear how proud you are and what a great job they did, or asking if they’d like to call a loved one to tell others how brave they were.
Be patient. Reconditioning any event is an ongoing process that will take time. You might go through all of these recommendations and still get unwanted behavior. This process should be repeated for every blood draw or routine event for months or years, and over time, the procedure will be conditionally known to be stress-free for your child.
Rachel Delano also recommends this flyer, which focuses on vaccines but can be used for any procedure that a child is nervous about.
