1. Use child-friendly language.
A blood pressure check could be “giving the arm a hug.” A swab could be a “silly tickle test.”
2. Biopsy ideas:
- Apply topical lidocaine under occlusion for 15-20 minutes before injection.
- Use buffered lidocaine (1:10 ratio of sodium bicarbonate to lidocaine).
- Suggestions for distraction: infants, use sweet-ease® sugar syrup on a pacifier; for older children use Buzzy™ for adjunctive pain control; play or sing the child’s favorite music.
3. If hospital-based, make use of child life specialists.
These specialists can suggest positioning for procedures. Often, having the parent hold or lay next to the child can be soothing.
4. End the visit on a positive note by offering the patient a sticker.
5. Ask permission.
To allay the anxiety of examining sensitive areas, I use a script: “As your parents have told you, people should not be looking at your bottom area. We are doctors and because you have a problem there, we need to take a look to help make it better. Do we have permission from you and mom/dad to take a look?”
