Position Child for Comfort
Try completing invasive procedures such as IV insertions and injections with the child in a sitting position instead of supine.1 "One of the developmental milestones achieved in infancy is the ability to sit up unsupported," notes Nancy Eckle, RN, MEN, CEN, a clinical nurse specialist at Children's Hospital in Columbus, OH. "After this milestone is reached, attempts to force an infant or child to lie down are often met with resistance, crying, and struggling to get up."
If a child is being given an IM injection in the thigh, the child should be positioned sitting on the side of the stretcher with the parent in front of the child. "The chest-to-chest position allows the parent to hug the child and secure the upper extremities," Eckle says. "The nurse then only needs to control the child's leg for the injection."
For an IV insertion in the hand, the child is positioned straddling the parent's lap, sitting chest-to-chest next to the stretcher. "The parent hugs the child, allowing the child's arm to rest on the stretcher," Eckle explains. With the parent holding the child, one staff member can secure and stabilize the child's arm while the nurse inserts the IV catheter into the child's hand.
Reference
1. Stephens B, Barkey M. Positioning for comfort. Association for the Care of Children's Health, Hurt Alert Day Resource. March 1994.
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