"My own experience (as one of a few MD's here that start IV's) with older children and adults is that using buffered lidocaine is very helpful to the patient and doesn't make the iv start any harder."
I do agree that buffered lidocaine is helpful. But it also involves a needle and this is where an anxious child will decompensate. In defence of the nurses, is this better than one stick with an angiocath?? Don't know??
How about Amethocaine? EMLA with NTG paste( as Alan Clark, suggests) or my FAVORITE, and as yet unrealized choice, a little nitrous oxide for a few minutes!!! If anesthesia can do it in the OR, why can't we provide provide a little "laughing gas" and make the whole experience "ouchless"!!
"I think that a little combination of resistance to change and desensitivation to patient discomfort on the part of the nursing staff makes implementation of proven methods to decrease discomfort
I partly agree, about the resistance to change. Desensitization........i don't think so. Most of the times these IV's are on "sick" kids who need access quickly. I can see why waiting 10 minutes for Numby to work may seem like an eternity!!
Kudos to you Virgil, for starting IV's.
Jay Pershad, M.D.
Lebonheur Childrens's Medical Center
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