Children’s hospitals have always looked for ways to make pediatric healthcare procedures less painful. One procedure that often causes anxiety is a blood draw or IV injection.
“Procedures requiring access to a vein can be stressful for many individuals and there are even more challenges associated with pediatric venipuncture: small veins, limited access points and managing the anxiety of the children and their families,” says pediatric vascular nurse Holly Hess.
Sprays and creams are often used to lessen pain, but may take up to 30 minutes to take effect and also may compromise the quality of the skin, or actually shrink the vein, when inserting the IV needle.
Hess, along with Child Life Coordinator Pat Kirkland and Clinical Nurse Leader Amanda Brown, thought they could do more to make blood draws and IV sticks as “ouchless” as possible and to ease children’s and parents’ anxiety. With a multidisciplinary team of about 15 that included a pharmacist, pediatric physician, staff nurses, Child Life and the sedation team, they developed a program at Wolfson Children’s Hospital called PANDA, which stands for “prepare” the patient, “analgesia” to reduce or eliminate pain, “new” technology, “distraction” and “allow” parents to hold their child in their arms during the procedure.
“Sometimes people take for granted that it’s just an IV stick or blood draw and it’s over quickly,” said Kirkland. “They think it’s not going to be a big deal for the child. But research actually shows that blood draws and IVs are what children most remember from their hospital stay and it can be traumatizing.”
One example of the new “ouchless” technology implemented at Wolfson is the J-Tip Needleless Injection System. It’s a device that delivers aerosolized Lidocaine, numbs the skin instantly and makes the IV insertion pain-free.
“The J-tip is not for every child,” said Hess. “It makes a loud pop as the cartridge releases the Lidocaine under the skin and, for children under the age of 3, that may be frightening.”
Wolfson Children’s Hospital is doing a trial of the J-Tip system with 200 patients. If successful, the hospital plans to adopt the new technology. The trial is being funded through the Children’s Miracle Network, which supports Wolfson Children’s Hospital and the pediatric programs at Shands Jacksonville.