LUV the J-tip, yes it makes a loud noise and can be a bit scary but it works nicely. Think about having the parent hold the child in a comforting hold (parent on the bed, child on top with parent's arms around the child) which helps decrease patient movement.

One can also use it for digital blocks, use the J-tip to numb the site where the needle will enter the skin; the child doesn't feel the initial poke, so they don't pull away their hand/foot.

Karen Kilian, ARNP
Urgent Care | Emergency Department
Seattle Children's
Past-President, Washington State Chapter NAPNAP
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-----Original Message-----
From: Pediatric Emergency Medicine Discussion List [mailto:[log in to unmask]] On Behalf Of Shae Ray
Sent: Wednesday, April 17, 2013 16:35
To: [log in to unmask]
Subject: Opinion on the J-tip procedure

I work in a small ER and see a very small amount of pediatric patients. The hospital I am out, has new pediatric protocols in place put in by one of our pediatricians. One protocol in particular I would love other nurses opinions on is when we are to start an iv on a child under the age of 12, we perform a procedure called a J-Tip procedure. That is where we numb the location on the extremity where we as the nurse think that it is our best chance is to get an iv. I have pros and cons about this. The pros are that we numb the child and it causes less pain from the iv insertion, however i found that the loud noise that it creates when administering the lidocaine is more traumatic then the actual iv itself. Also no matter how pain free the procedure, holding down a child down, depending on their age, causes the child to be upset anyways. It also can cause a mark on the child's tiny little hand where it manipulates the iv site. So would love some feedback on this topic? Is it a good protocol for our hospital or is there a better way?

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