Monday, March 30, 2009

Finger pokes

Finger pokes are different from blood draws in several ways. First, EMLA can be used
successfully. Put a blob of EMLA on the tip of the middle finger. Cover the fingertip
with plastic wrap, and tape it on the finger. Another method is to buy long, thin
balloons with a diameter a bit wider than the child’s finger. Cut off the open end,
leaving only enough balloon to cover the finger up to the first knuckle. Fill the tip of
the balloon with EMLA and slide it on the fingertip. EMLA needs to be applied an
hour before a finger poke to be effective. At the laboratory, remove the plastic wrap
or balloon, wipe off the EMLA, and ask for a warm pack. Wrapping this heated pack
around the finger for a few minutes opens the capillaries to allow the blood to flow
out more readily. Now the child is ready for a pain-free finger poke.
The technician will hold the finger and quickly stick it with a small sharp instrument.
Blood will be collected in narrow tubes or a small container. It is usually necessary for
the technician to squeeze the fingertip to get enough blood. If EMLA is not used, the
squeezing part is uncomfortable and the finger can ache for quite a while.
Even though we use EMLA, Katy (5 years old) still becomes angry
when she has to have a finger poke. I asked her why it was upsetting if
there was no pain, and she replied, “It doesn’t hurt my body anymore,
but it still hurts my feelings.”