Comfort choices project offers more ways to manage children’s pain

Mom Meenu (Amandip) Bansal (who works in nursing education) demonstrates a comforting position with her son, Reyan.

During a hospital visit, painful procedures such as needle pokes for drawing blood or starting an IV can be stressful for patients of any age. Young children who do not understand what is happening may squirm or try to pull away, making the procedure even more difficult and stressful for everyone involved.

At Akron Children’s, our child life team plays an important role in helping children cope with being in the hospital – from keeping them calm and comfortable during procedures to showing them what to expect when having surgery.

Through an initiative called comfort choices, the child life team is teaching other hospital staff how to use simple techniques to ensure every patient is as comfortable as possible during procedures or tests. These techniques offer an alternative to pain medication and may be as simple as distracting the child with toys or bubbles or applying an aerosol spray that numbs the skin before a needle poke.

Mom Tiffany Gray (who is also a child life specialist) demonstrates a comfort position, “chest to chest,” to her daughter, Melanie, as Child Life Specialist Laura Leindecker and RN Megan Foster give medical care.

“Through this project, we’ve created a menu of comfort choices that can be used by anyone on the patient’s care team,” said Tiffany Gray, a child life specialist who is part of the group working on these efforts. “These techniques do not require a doctor’s order or any extra cost to use.”

Depending on the age of the child, parents and providers may choose any of these comfort choices to reduce pain and stress during procedures:

• Comfort positioning. Parents are encouraged to hold and support their child in one of several comfort positions that help the child feel safe and secure.

• Parental presence. Often just having a parent or caregiver in the room during a procedure can be a great source of comfort.

• Ice/heat. Applying ice or heat to painful areas can aid in pain relief.

• Elevation. Elevating extremities may be used to decrease swelling and pain.

• Distraction. Depending on the child’s age and interests, a variety of distractions may be used such as bubbles, an iPad, games, toys, music or videos.

• Pain Ease. This aerosol spray numbs an area before needle pokes or IV starts.

• Buzzy device. This bee-shaped device vibrates and has ice pack wings. It may be placed near an IV or injection site to distract the child from pain and replaces the use of ice packs. It is often used with Pain Ease.

• Home preference. Finding out what parents use at home or what has worked for other hospital visits may be helpful, while also involving families in choosing the best option for their child.

• Deep-breathing techniques. Encouraging children to focus on deep breathing helps promote relaxation and reduces stress.

• Guided imagery. Helping children relax by imagining a comforting scenario may be used with older kids.

• Meditation/relaxation. Like guided imagery and deep breathing, meditation may be encouraged to promote relaxation.

• Sweet Ease. For young children ages 6 to 8 months, Sweet Ease sugar water may be applied to a pacifier to help block pain.

• Hand squeezing/stress balls. Squeezing a parent’s hand or stress ball may help distract a child from pain.

• Low stimulation. Before starting a procedure, providers may create a soothing environment by dimming the lights and closing the door.

• One voice. When several staff or family members are present, keeping conversations to a minimum can also create a quiet, soothing environment.

• Child life support. Our child life specialists are available to provide assistance with comfort choices or to answer questions.

As the comfort choices initiative continues to be rolled out, the team will be working on educating staff and parents about these options.

Mom Jordyn Rhoades demonstrates a comfort position, “side sitting,” with Adrianna Montgomery.

“Letting patients and families choose which techniques are used gives them control in situations where they often feel like they have little or no control,” said Gray. “It could be as simple as cuddling with your child.”

While these techniques may be easy to use, they’re also very beneficial.

“Although we don’t have any data yet from patient surveys, we’ve received positive comments from parents regarding how this has created a much better hospital experience for their child,” Gray said.