Instructions to parent(s) to help minimize the pain of shots
Choose the shot spot according to the photos below and the age of your child. Clean the skin with soap and water (you do not need to use an alcohol swab), and pat dry. Apply EMLA cream available from your local pharmacy to the indicated area and cover with a Tegaderm Transparent Dressing, ideally for one hour before doctor’s appointment. You may need a prescription for EMLA; ask your pharmacist. Please call days before if you need an Rx.
EMLA Cream consists of a 1:1 mixture of lidocaine and prilocaine. EMLA prevents pain associated with topical skin procedures. Although EMLA Cream can be an OTC (Over The Counter) product, available in pharmacies, some pharmacies require a prescription. Please contact me if you need an Rx.
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Where to Apply EMLA cream covered by TegaDerm
For children over age 1-2 yrs of age:
Depending on sufficient flesh. This is the top, upper part of the arm. The non-dominant arm is generally preferred for 1 or 2 shots.
Cover the indicated area with EMLA cream, using a sufficient amount to leave skin surface wet and glistening; cover immediately with TegaDerm.
Do not wait for EMLA to dry before covering with patch.
For infants under age 12-18 months, use the thighs: The middle of the front outer side of the thigh. Do not use the inner thigh, side or back of the thigh. Divide the thigh into thirds; the injection site is in the middle third section
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How To Use
Step 1
Peel away the printed liner from the paper-framed dressing, exposing the adhesive surface.
Step 2
Apply dressing over correct area covering EMLA cream where applied. See photos below. DO NOT STRETCH the dressing when applying.
Remove the paper frame from the dressing while smoothing down the edges.
Apply the Tegaderm Patch over EMLA at least one hour before your appointment; The doctor will remove the patch on arrival.
How to make injections less painful for your child
Medicines
Topical anesthetic agents, such as EMLA, lidocaine (Maxilene®), tetracaine (Ametop®) can be applied for one hour before giving the injection. Follow the directions on the packet.
Sugar mixture (Oral sucrose 24%). You can make this at home by mixing one packet (1 tsp) of sugar to two tsp of water. Place a few drops of the mixture onto your baby’s tongue, a few minutes before the injection. Give a few drops right as you are giving the injection.This will make it less painful for your baby. You do not need to give all of the sucrose mixture to the baby. This works in children up to 18 months of age.
How to make injections less painful for your child
Distraction
Babies can be distracted with colourful mobiles and mirrors. Younger children can be distracted with blowing bubbles or party blowers, reading a favourite book, playing with a musical toy or with the use of virtual reality glasses. Older children can choose what they wish to be distracted with: a hand-held video game, for example.
Imagery and Relaxation
Ask your child to try to imagine a pleasant experience. As your child focuses on something other than the pain, ask them to describe it using all their senses. Your child can also pick an image that feels relaxing to them. You can also suggest other sensations such as sound, smell, taste and touch that go with the situation. You may suggest that as they breathe steadily in and out, they are blowing away the tension in their muscles.
More reduction of pain for babies and toddlers
Straddle Position can help steady your child for the shot & soothe at the same time.
Straddle your baby on your lap so that baby is facing you and the limbs are on each side of you. This is similar to giving your child a ‘bear-hug'.This position is easy to do when there are two people present. The other person, the doctor, can inject on one of the injection sites that you have prepared as you securely hold your baby in place. Alternatively, you can swaddle your baby in a blanket, leaving the limb out for injection.
Breastfeeding is a good time to give your baby an injection. This will make the injection less painful. This works when the doctor is available to give the injection while you are feeding. Or let your child suck on a pacifier during the injection. Many toddlers and babies find this soothing and feel less pain during the injection. You can also dip the pacifier in the sugar mixture (described above).
Please contact your doctor if you have any questions about preparation for immunization shots or need an Rx for EMLA (ask your pharmacist).