Preparing Children for Medical Procedures: Invasive & Non-Invasive

You can expect our medical staff ….

• Will only carry out essential distressing and/or invasive procedures.
• Will keep the number of people present during the procedure to a minimum to reduce potential stress.
• Will work with colleagues to ensure that the requirements for different disciplines (e.g., microbiology and dietetics) are accommodated with the minimum number of procedures required for your child.
• Will seek information about your child’s previous experience of similar procedures; assess the child’s affect and developmental level and proceed accordingly.
• Will introduce themselves to both you and your child (if you don’t already know the staff member) which helps to establish rapport.
• Will explain why the procedure is necessary, how it is done, how it helps and any possible outcome
• Will give sufficient time for the topical local anesthetic cream (if required) to be fully effective.
• Will explain in detail in a caring manner, what the actual procedure involves, how and when it will be carried out, what it might feel like at the time, and afterwards.
• Will be honest and will not give false reassurances (e.g., “this won’t hurt”).
• Will check in with your child around their understanding and allow time for questions and handle any expressed fears calmly and sympathetically.
• Will check your level of comfort/distress to ascertain if you are able to support your child during the procedure or if alternative support arrangements need to be made.
• Will establish the need for assistance from a specialist e.g., play specialist/psychologist [if available] or from a team member who has a good relationship with the child.

• Play materials and equipment around children undergoing similar procedures can be very useful for explaining things to younger children.
• It is helpful to ‘desensitise’ the child to the medical equipment by allowing him/her to handle it [if possible]. Anxiety can be relieved for your child if the clinician can demonstrate the procedure first on a doll, on him/herself or on you.
• Use distraction, to help your child get through the procedure. See below for a list of effective distraction techniques for children. The aim is to detract attention away from procedures which they may find distressing, towards more interesting and pleasant things. Note: the more interactive and varied the technique, the greater likelihood that distress will be reduced.
• It is helpful if you or another adult can actively participate and take the lead in the distraction.
• Patting, stroking and rubbing can all provide a physical distraction from pain and discomfort for children, an alternative focus, as well as providing comfort.
• Music and songs are a valuable distraction for younger children [e.g., videos, nursery rhymes, favourite cartoons]; older children and teenagers could enjoy ‘YouTube’ clips or perhaps their own music on IPods/MP3 players, etc.
• Help your child to use breathing techniques to reduce their anxiety levels and to manage their discomfort and pain. Practice ‘belly breathing’ beforehand [if possible] –place one hand or teddy on your belly, breathe in for five and out for seven seconds. You can assist by counting the breaths and doing it with your child; this will help your child to engage and sustain the technique
• Use a visual aid for younger children suggesting that they breathe in deeply as if smelling a beautifully fragrant rose and blow out slowly as if blowing out a candle. As an alternative, medical staff make use of bubbles or party blowers!
• Square Breathing is a simple and fun, yet effective mindful breathing exercise suitable for both older children and the parent/carer present. You are required to inhale slowly through your nose for 4 seconds. Hold your breath for 4 seconds, then exhale slowly through your nose or mouth for 4 seconds. Hold your breath for 4 seconds before inhaling for another round of Square Breathing. Repeat as often as you like until you feel calmer.
• All adults involved should pay attention to verbal and non-verbal cues from the child and use positive directions whenever possible, e.g., “it’s time to stay still” rather than “don’t move”.
• Stay calm if the child’s distress levels escalate. In such a situation, you may need to allow the child to take a little break before resuming the procedure. If this second attempt fails, consider whether the procedure can be postponed. With further preparation and training before the next appointment, it is more likely to be successful.
• Ensure that you and the clinician use praise effectively as this can reinforce cooperation and coping skills.
• Use stickers/badges or other developmentally appropriate reward to mark the child’s bravery.
• Sedation or restraint may be unavoidable if the procedure is urgent; refer to the relevant specialists for advice and guidance.