Where's Our Distraction?

From a purely medical perspective, IV (intravenous or putting medicine directly into a vein) inductions are the best way to go off to sleep.

What if you have an emergency laryngospasm upon induction? 
We fix that with drugs through your cannula

Gas inductions have made everyone sleepy?
Let's avoid them altogether

Unscavanged gases tearing a hole in the Ozone layer and causing untold amounts of air pollution?
Let's use a closed circuit system and have an IV induction

Is that mask making you feel claustrophobic?
Let's avoid using it while you're awake.

Spouting that the benefits of a IV induction is better is all well and good, but many of us are very distrusting or even straight up afraid of needles. Too often we aren't properly prepared for what it will feel like, or we are caught in the grip of a traumatic past experience. How do we, in paediatrics, get some patients to feel calm, settled, and supported enough to have a cannula?

The answer, is distraction.

...and numbing creams / sprays.
 
For distraction I am a fan of the Where's Wally books (also known as Where's Waldo where I'm from) or any number of other search and find books.. These books are incredible at pulling your brain away from things that are happening around you, using their chaotic imagery and ability to tap into competitive / completionist natures.

I personally own a lot by Paul Moran. He does books such as Where's the Unicorn, Where's the Llama, Where's the Meerkat, etc etc.

You see, it's my job to help you get comfy in the anaesthetic room, either on the trolley or on your loved one's lap, we're gonna get your numbed hand nice and clean and let the doctor and ODP give your arm a squeeze and tap on you while I use the book as a gloriously large, chaotic screen. Sometimes you and I will race, who can find the most - the fastest. Other times we will work collaboratively, both making sure that we see where everyone is. Sometimes we get your loved ones to look as well, see if they're as much of an expert as you are. If I see your attention beginning to wander to what is happening to your hand, I may say silly things like "Does this bicycle count as a unicorn?!" to pull your attention back to me and you can and probably will give me the strangest looks - like how did I even get this job, of course it doesn't count. 

If things have gone well, then I can point out how brilliant you were and how getting an IV doesn't have to be scary, does it? Sometimes our brains make it feel more scary than it needs to be.

If it doesn't go well.... Sometimes we just need to swap sides, swap hands - your newly released hand having a little piece of tape and gauze stuck to it. Sometimes we need to stop and say "Well, we gave it a good go, but I don't think this is working." and change tactics doing a gas induction instead.

Overall, we just need to be flexible with what you need when you come visit us. I am a firm believer that we as healthcare practitioners should allow you be empowered in your healthcare. I believe that we should do as little harm as possible. I believe we should be adapting to your needs, not making you adapt to ours.

I also believe all parents should have some version of these books any time they need to go somewhere where a little distraction could be calming and productive.

I promise I'm not just saying this because I love having a look through these books and I can assure you're never too old to have a go at them. I often see my colleagues clustered around my stack of books in a spare moment - no matter how many times we see them, we forget where everything is hidden!



Comments

  1. I do miss searching for the unicorns! *sigh*

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