variability in blood draw experience

[ktsmom]

I am looking for tips and stories about if/how you make a blood draw go better for your child from the lab and technician standpoint. It's not preparing and handling my daughter that I have questions about. We have a pretty good system. What I need help with is how to ask/tell the lab techs things without ticking them off. I'm asking because Friday's blood draw for her annual visit was one of the worst experiences in the history of all bad blood draws. And if the lab tech is doing a lousy job, all of my techniques with my daughter go out the window because she's 7 and once she loses it, we can't get it back! I am now on a quest to determine the proper pediatric blood draw protocol so that I can be a better advocate.

When we go downstairs to the lab in the professional building, we never know who we are going to get, but we have had several blood draws go very well there. I followed my usual routine there on Friday, which basically consists of asking for someone experienced in pediatrics. Apparently you can ask a tech if they are experienced in pediatrics, but if they say yes and it turns out they aren't, it's too late. We are in a hospital complex and there are several other lab locations available. Do any of you call ahead and ask for a supervisor? What, if any, conversations do you have with the technician to make things go smoothly? I felt the tech was doing some things wrong Friday but I wasn't sure enough to say anything. She put the tourniquet on and then left the room, for example.

Like most CF'ers we've had way too many experiences with needles: many blood draws from being in the Denufosol clinical trial, blood work for her annual visit, and IV's placed for surgeries and ER procedures. Maybe I'm making too much of it, but for crying out loud routine blood draws should go as easy and with as less pain as possible, especially knowing other things that might lie ahead (we've also been through a gastrograffin enema). So blood draws are pretty much the only thing where I have any hope of controlling the circumstances.

And if the tech Friday didn't follow proper protocol and shield the Vitamin A and E vials like I reminded them too (and they semi argued with me), and we need a re-do I will come undone. Grrrr.

 

[ktsmom]

I am looking for tips and stories about if/how you make a blood draw go better for your child from the lab and technician standpoint. It's not preparing and handling my daughter that I have questions about. We have a pretty good system. What I need help with is how to ask/tell the lab techs things without ticking them off. I'm asking because Friday's blood draw for her annual visit was one of the worst experiences in the history of all bad blood draws. And if the lab tech is doing a lousy job, all of my techniques with my daughter go out the window because she's 7 and once she loses it, we can't get it back! I am now on a quest to determine the proper pediatric blood draw protocol so that I can be a better advocate.

When we go downstairs to the lab in the professional building, we never know who we are going to get, but we have had several blood draws go very well there. I followed my usual routine there on Friday, which basically consists of asking for someone experienced in pediatrics. Apparently you can ask a tech if they are experienced in pediatrics, but if they say yes and it turns out they aren't, it's too late. We are in a hospital complex and there are several other lab locations available. Do any of you call ahead and ask for a supervisor? What, if any, conversations do you have with the technician to make things go smoothly? I felt the tech was doing some things wrong Friday but I wasn't sure enough to say anything. She put the tourniquet on and then left the room, for example.

Like most CF'ers we've had way too many experiences with needles: many blood draws from being in the Denufosol clinical trial, blood work for her annual visit, and IV's placed for surgeries and ER procedures. Maybe I'm making too much of it, but for crying out loud routine blood draws should go as easy and with as less pain as possible, especially knowing other things that might lie ahead (we've also been through a gastrograffin enema). So blood draws are pretty much the only thing where I have any hope of controlling the circumstances.

And if the tech Friday didn't follow proper protocol and shield the Vitamin A and E vials like I reminded them too (and they semi argued with me), and we need a re-do I will come undone. Grrrr.

 

[ktsmom]

I am looking for tips and stories about if/how you make a blood draw go better for your child from the lab and technician standpoint. It's not preparing and handling my daughter that I have questions about. We have a pretty good system. What I need help with is how to ask/tell the lab techs things without ticking them off. I'm asking because Friday's blood draw for her annual visit was one of the worst experiences in the history of all bad blood draws. And if the lab tech is doing a lousy job, all of my techniques with my daughter go out the window because she's 7 and once she loses it, we can't get it back! I am now on a quest to determine the proper pediatric blood draw protocol so that I can be a better advocate.
<br />
<br />When we go downstairs to the lab in the professional building, we never know who we are going to get, but we have had several blood draws go very well there. I followed my usual routine there on Friday, which basically consists of asking for someone experienced in pediatrics. Apparently you can ask a tech if they are experienced in pediatrics, but if they say yes and it turns out they aren't, it's too late. We are in a hospital complex and there are several other lab locations available. Do any of you call ahead and ask for a supervisor? What, if any, conversations do you have with the technician to make things go smoothly? I felt the tech was doing some things wrong Friday but I wasn't sure enough to say anything. She put the tourniquet on and then left the room, for example.
<br />
<br />Like most CF'ers we've had way too many experiences with needles: many blood draws from being in the Denufosol clinical trial, blood work for her annual visit, and IV's placed for surgeries and ER procedures. Maybe I'm making too much of it, but for crying out loud routine blood draws should go as easy and with as less pain as possible, especially knowing other things that might lie ahead (we've also been through a gastrograffin enema). So blood draws are pretty much the only thing where I have any hope of controlling the circumstances.
<br />
<br />And if the tech Friday didn't follow proper protocol and shield the Vitamin A and E vials like I reminded them too (and they semi argued with me), and we need a re-do I will come undone. Grrrr.
<br />

 

[JORDYSMOM]

Dana, I know what you mean. Of course we use the same lab. <img src="i/expressions/face-icon-small-wink.gif" border="0"> You might ask Doc R's office to call & request a specific tech or suggest one for you. Maybe they know who is better with kids??

You might also call the lab, ask to speak with the supervisor, and explain the situation without naming anyone. Leaving a tourniquet on a child is unacceptable. Maybe not painful, but uncomfortable, and leaves too much time for her to panic. Just tell them that you need to know who you should request in the future, so that the procedure will be less traumatic for your child.

I hope you don't have to re-do the draws. I'd be upset too.

I will get together soon. <img src="i/expressions/face-icon-small-smile.gif" border="0">

Stacey

 

[JORDYSMOM]

Dana, I know what you mean. Of course we use the same lab. <img src="i/expressions/face-icon-small-wink.gif" border="0"> You might ask Doc R's office to call & request a specific tech or suggest one for you. Maybe they know who is better with kids??

You might also call the lab, ask to speak with the supervisor, and explain the situation without naming anyone. Leaving a tourniquet on a child is unacceptable. Maybe not painful, but uncomfortable, and leaves too much time for her to panic. Just tell them that you need to know who you should request in the future, so that the procedure will be less traumatic for your child.

I hope you don't have to re-do the draws. I'd be upset too.

I will get together soon. <img src="i/expressions/face-icon-small-smile.gif" border="0">

Stacey

 

[JORDYSMOM]

Dana, I know what you mean. Of course we use the same lab. <img src="i/expressions/face-icon-small-wink.gif" border="0"> You might ask Doc R's office to call & request a specific tech or suggest one for you. Maybe they know who is better with kids??
<br />
<br />You might also call the lab, ask to speak with the supervisor, and explain the situation without naming anyone. Leaving a tourniquet on a child is unacceptable. Maybe not painful, but uncomfortable, and leaves too much time for her to panic. Just tell them that you need to know who you should request in the future, so that the procedure will be less traumatic for your child.
<br />
<br />I hope you don't have to re-do the draws. I'd be upset too.
<br />
<br />I will get together soon. <img src="i/expressions/face-icon-small-smile.gif" border="0">
<br />
<br />Stacey
<br />
<br />
<br />
<br />

 

[hmw]

We've had traumatic draws with Emily too- she has these tiny veins that tend to collapse and roll no matter how hydrated she is and after one particular draw that resulted in several blown veins (and me about to blow my top) I swore off anyone that did not EXCLUSIVELY do kids, because I was so done with those techs that merely claim to be 'good with kids' but are totally full of it. So she gets all labs now at Children's. I will make the drive even if it's something the pediatrician needs, because I know we will get someone there who only works on kids.

Oh, and they seem to get a better stick when she doesn't have the emla patch too. The last two times we tried it w/ emla she needed to be poked twice to get all the vials they needed. Not that I want the labs to hurt, but she doesn't like the numb feeling of the patch on her skin for so long anyway, so we don't use it.

I'm so sorry you had such a bad experience. You are so right: we can work so hard to get them prepared etc etc- and if they can undo it sooo easily!

 

[hmw]

We've had traumatic draws with Emily too- she has these tiny veins that tend to collapse and roll no matter how hydrated she is and after one particular draw that resulted in several blown veins (and me about to blow my top) I swore off anyone that did not EXCLUSIVELY do kids, because I was so done with those techs that merely claim to be 'good with kids' but are totally full of it. So she gets all labs now at Children's. I will make the drive even if it's something the pediatrician needs, because I know we will get someone there who only works on kids.

Oh, and they seem to get a better stick when she doesn't have the emla patch too. The last two times we tried it w/ emla she needed to be poked twice to get all the vials they needed. Not that I want the labs to hurt, but she doesn't like the numb feeling of the patch on her skin for so long anyway, so we don't use it.

I'm so sorry you had such a bad experience. You are so right: we can work so hard to get them prepared etc etc- and if they can undo it sooo easily!

 

[hmw]

We've had traumatic draws with Emily too- she has these tiny veins that tend to collapse and roll no matter how hydrated she is and after one particular draw that resulted in several blown veins (and me about to blow my top) I swore off anyone that did not EXCLUSIVELY do kids, because I was so done with those techs that merely claim to be 'good with kids' but are totally full of it. So she gets all labs now at Children's. I will make the drive even if it's something the pediatrician needs, because I know we will get someone there who only works on kids.
<br />
<br />Oh, and they seem to get a better stick when she doesn't have the emla patch too. The last two times we tried it w/ emla she needed to be poked twice to get all the vials they needed. Not that I want the labs to hurt, but she doesn't like the numb feeling of the patch on her skin for so long anyway, so we don't use it.
<br />
<br />I'm so sorry you had such a bad experience. You are so right: we can work so hard to get them prepared etc etc- and if they can undo it sooo easily!

 

[TonyaH]

Another thing Andrew always asks for is a butterfly needle. Believe it or not, some techs don't automatically start with a butterfly. Andrew learned that early and now that is the first thing he asks when a tech walks in the room. I just stand back and smile because once they realize he is up to speed on what is going on, they get with the program and do a pretty good job with him.

 

[TonyaH]

Another thing Andrew always asks for is a butterfly needle. Believe it or not, some techs don't automatically start with a butterfly. Andrew learned that early and now that is the first thing he asks when a tech walks in the room. I just stand back and smile because once they realize he is up to speed on what is going on, they get with the program and do a pretty good job with him.

 

[TonyaH]

Another thing Andrew always asks for is a butterfly needle. Believe it or not, some techs don't automatically start with a butterfly. Andrew learned that early and now that is the first thing he asks when a tech walks in the room. I just stand back and smile because once they realize he is up to speed on what is going on, they get with the program and do a pretty good job with him.

 

[hmw]

I agree Tonya- esp once they are your son's age they do not! Shawn since he was about 11 goes straight for the 'big needle' since he wants it over with faster and hates, as he puts it, the 'sucking' feeling of the butterfly. But Tim (11) freaks out if he doesn't have a butterfly, and not all places will routinely offer one with kids their age.

 

[hmw]

I agree Tonya- esp once they are your son's age they do not! Shawn since he was about 11 goes straight for the 'big needle' since he wants it over with faster and hates, as he puts it, the 'sucking' feeling of the butterfly. But Tim (11) freaks out if he doesn't have a butterfly, and not all places will routinely offer one with kids their age.

 

[hmw]

I agree Tonya- esp once they are your son's age they do not! Shawn since he was about 11 goes straight for the 'big needle' since he wants it over with faster and hates, as he puts it, the 'sucking' feeling of the butterfly. But Tim (11) freaks out if he doesn't have a butterfly, and not all places will routinely offer one with kids their age.

 

[NanaOf8GirlsAndCounting]

Wow, this sounds so familiar. Seems like they always have trouble with Graycies veins. The last time she was in the hospital there was one woman who could stick her once and be done with it. They were taking blood every hr for a few days before and after her surgery. Most of them blamed her veins blowing out and had to stick her many times even walked in on them trying from her foot, before my daughter finally told them enough and to get the other lady down here. Graycie was so bruised from them digging for her veins it was awful. They weren't allowed to draw from her PICC line or her IV or so they said but when we went to Cincinnati they took it out of her IV and was great with her. If you find one who is good with your child you need to get their name and request them. Its tramatic enough without having to be poked over and over again.

 

[NanaOf8GirlsAndCounting]

Wow, this sounds so familiar. Seems like they always have trouble with Graycies veins. The last time she was in the hospital there was one woman who could stick her once and be done with it. They were taking blood every hr for a few days before and after her surgery. Most of them blamed her veins blowing out and had to stick her many times even walked in on them trying from her foot, before my daughter finally told them enough and to get the other lady down here. Graycie was so bruised from them digging for her veins it was awful. They weren't allowed to draw from her PICC line or her IV or so they said but when we went to Cincinnati they took it out of her IV and was great with her. If you find one who is good with your child you need to get their name and request them. Its tramatic enough without having to be poked over and over again.

 

[NanaOf8GirlsAndCounting]

Wow, this sounds so familiar. Seems like they always have trouble with Graycies veins. The last time she was in the hospital there was one woman who could stick her once and be done with it. They were taking blood every hr for a few days before and after her surgery. Most of them blamed her veins blowing out and had to stick her many times even walked in on them trying from her foot, before my daughter finally told them enough and to get the other lady down here. Graycie was so bruised from them digging for her veins it was awful. They weren't allowed to draw from her PICC line or her IV or so they said but when we went to Cincinnati they took it out of her IV and was great with her. If you find one who is good with your child you need to get their name and request them. Its tramatic enough without having to be poked over and over again.

 

[TonyaH]

Hi Cheryl,
You may already know this, so forgive me if so. There are some lab tests that cannot use blood samples drawn through the same line that was used to deliver medication. For example, when Andrew has a picc placed we always keep his peripheral iv in for administering his medication until it is time to go home. Since his tobramycin, gentamycin, etc. are run through his peripheral, they can get drug levels through his picc, which has not had any of the medication running through it. Once all of his levels are good to go, we start using the picc line to administer meds. So, if you have been told the picc can't be used for a blood sample it may because they are testing her drug levels and need the sample from a clean line or vein.

 

[TonyaH]

Hi Cheryl,
You may already know this, so forgive me if so. There are some lab tests that cannot use blood samples drawn through the same line that was used to deliver medication. For example, when Andrew has a picc placed we always keep his peripheral iv in for administering his medication until it is time to go home. Since his tobramycin, gentamycin, etc. are run through his peripheral, they can get drug levels through his picc, which has not had any of the medication running through it. Once all of his levels are good to go, we start using the picc line to administer meds. So, if you have been told the picc can't be used for a blood sample it may because they are testing her drug levels and need the sample from a clean line or vein.