< Previous | Contents | Next >

Restraining children for procedures

Restraint is important both for the child and for the clinician who is undertaking the procedure. Clearly, the procedure will be undertaken more quickly, safely and accurately if the child is kept still. However, to prevent a child with a chronic condition who will experience many such procedures being made fearful of further attempts, sedation should be strongly considered if facilities are available for this.

If facilities do not allow or if the procedure is unlikely to require repetition, physical restraint can be used. Ideally a parent or trusted friend or relative can actually hold the

child. It is also very helpful to use distraction techniques such as singing a song, telling a story or using a glove puppet. Blowing soap bubbles is a very useful distraction for children, and it costs very little to bend a piece of wire into a loop and make up some strong soap solution.

First explain to the child in an age-appropriate manner what is going to happen. Never say ‘This won’t hurt’ when you know it will. Always use local analgesia if at all possible (see Section 1.15). Explain why they are to be wrapped up (a ‘big cuddle’), what is to happen and what will happen afterwards. Give plenty of praise before, during and after the procedure.

Restraining a child for examination does not usually require wrapping, but it is wise to leave examination of the ears, nose and throat until the end of the examination.



image


FIGURE 8.1.1 Wrapping a child so that they can be held securely for a procedure. (a) and (b). One end of a folded sheet should be pulled through under the arms on both sides. (c) and (d). The other end is then brought across the front and wrapped round the child.

image


FIGURE 8.1.2 Holding a child for examination of the eyes, ears and throat.  

 

< Previous | Contents | Next >