I have taken a new job as a leader in a mobile vascular access company. One of our largest clients are asking us to place lines in a pediactric hospital. I do have clinicains with pediatric experience, but we are looking at writing some formal policies about line placement in this population. One of the biggest questions we have is how do facilities determine when to use conscious sedation, pre-medicate with perhaps benadryl or valium and when to not use any type of seditive or advanced sedation?
I am looking for supporting documents for this practice as well as what clinicains are doing in real practice.
Any guidance will be appreciated.
Don't forget use of Child Life Therapist and no drugs. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
We don't place a lot of pediatric PICCs but we talk with the parents and nursing staff: how does the child handle IV starts or blood draws? Are they able to hold still consistently while being distracted? I always tell the child that they can cry or holler or say whatever they want, they just can't move. We always involve a second PICC nurse whenever possible as well as a peds nurse for the distraction part of the procedure. We like to use buffered lidocaine rather than EMLA - it's much faster and doesn't give the child an hour to REALLY get scared, and there go all the veins!
If they won't hold still, some form of sedation is necessary - then our IR dept. will place the line with anesthesia there doing the sedation.
If possible, don't delay the placement once you have decided to do, it based on your assessment - move forward and get it done - reduces the terror reaction! Good luck!
Wendy Erickson RN
Eau Claire WI