Tuesday, January 19, 2016

Child Life in Wound Care

Child life in Wound Care

One of the places that I get to facilitate preparation and distraction in our hospital is wound care. About 45% of the time, I have already met these children up on the pediatric floor from their first admission for the initial injury, so the rapport has already been established. For the children that I don't know, we do a little waiting room activity in order for me to get to know them and be their friend in the wound care room.

Preparation: One issue I run into with wound care is unless I know the child from the floor, I am not familiar with their injury. In this case, I do not know what the doctor will be doing until he is in the room, leaving little time for preparation. I tend to use a lot of stress point preparation (i.e. "This is what is happening now..." and "This is what will happen next...")

Tip: Ask the parent if they know what is happening today to at least get a little background

Tip: If you are squeamish at wounds or burns stay at the head of the bed and away from the wound. You can sit down on a stool so you don't faint (don't feel bad, everyone has something they don't like).

Distraction: Wound care can sometimes be very painful. It is a good idea to get the child distracted before the procedure even begins. This makes it easier to redirect them once they are engaged. I recommend an iPad because wound care tends to last a longer than other procedures. The iPad offers many different choices, so if a child is getting bored or restless they can change the game or video. My teens love to play music on Pandora and watch videos on YouTube.
For younger children, I recommend a light spinner, bubbles, and a toy that makes a funny noise. Something with a button that  they can push so their hands are kept busy and out of the doctors and nurses way.

Tip: Sometimes you won't be able to distract through the pain, and that's okay. 

Tip: Offer comfort positions, but be aware that some wounds have to be a certain way and sometimes comfort positions will not be allowed. 

What about you? Are you a child life specialist that works in wound care? What tips do you have?  



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