{"id":1276,"date":"2016-04-08T20:55:50","date_gmt":"2016-04-08T19:55:50","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/adc\/?p=1276"},"modified":"2016-04-07T16:16:02","modified_gmt":"2016-04-07T15:16:02","slug":"i-dont-want-that-needle-aka-do-fewer-things","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/adc\/2016\/04\/08\/i-dont-want-that-needle-aka-do-fewer-things\/","title":{"rendered":"&#8220;I don&#8217;t want that needle!&#8221; (AKA Do fewer things)"},"content":{"rendered":"<p>We (doctory, paediatric types) tend to pride ourselves on minimising distress to children and young people wherever possible. A couple of social media interactions over the last few days have made me re-question that &#8211; this one<\/p>\n<blockquote class=\"twitter-tweet\" data-width=\"550\" data-dnt=\"true\">\n<p lang=\"en\" dir=\"ltr\">..also responsibility to not create unnecessary fear. Not all blood tests go smoothly. Did the child really need it?<a href=\"https:\/\/t.co\/eO2n15lzjB\">https:\/\/t.co\/eO2n15lzjB<\/a><\/p>\n<p>&mdash; Damian Roland (@Damian_Roland) <a href=\"https:\/\/twitter.com\/Damian_Roland\/status\/717804173690028033?ref_src=twsrc%5Etfw\">April 6, 2016<\/a><\/p><\/blockquote>\n<p><script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script><\/p>\n<p dir=\"ltr\" lang=\"en\">and the follow-up<\/p>\n<blockquote class=\"twitter-tweet\"><p>&nbsp;<\/p>\n<p>https:\/\/twitter.com\/spencer_sian\/status\/717985681893691392<\/p><\/blockquote>\n<p>&nbsp;<\/p>\n<p><!--more--><\/p>\n<p>Now that&#8217;s a great time to re-acquaint yourself with <a href=\"https:\/\/stg-blogs.bmj.com\/adc\/2016\/03\/23\/guest-post-asking-questions-engaging-children-and-young-people-in-healthcare\/\">the guest blog from Sian about asking questions to children, <\/a>and perhaps some stuff about the use of <a href=\"https:\/\/stg-blogs.bmj.com\/adc\/2015\/10\/02\/clashing-concepts\/\">pain relief in venipuncture, <\/a>and then take on the challenge of that last question<\/p>\n<blockquote><p><em>&#8220;..is this\u00a0absolutely\u00a0necessary&#8221;<\/em><\/p><\/blockquote>\n<p>What does &#8216;absolutely necessary&#8217; mean? Is there ever a blood test that is\u00a0<em>absolutely necessary?<\/em><\/p>\n<p>Taking an\u00a0extreme example, you have a toddler\u00a0presenting with clinical pallor over 3-4 weeks, bruising spontaneously, lethargy, and palpable liver and spleen. (I&#8217;m really hoping that acute leukaemia is on the top of your lists here &#8230;) If you couldn&#8217;t do a blood test, could you still\u00a0manage this situation?<\/p>\n<p>What about a child who&#8217;s hot, annoying, breathing a bit quick and looks a tad dry?<\/p>\n<p>What about a teen who&#8217;s finding getting up in the morning a struggle, is tetchy and snappish, and constantly complains to anyone who will listen about tiredness?<\/p>\n<p>We&#8217;re always going to live in a world of compromises. If you&#8217;re visiting a child who&#8217;s receiving end of life care at home, you&#8217;re going to act differently than if it&#8217;s a previously well child attending the acute assessment area. If you have a radiographer two doors down from your clinic, you might think differently about a chest X-ray than if you&#8217;re in a\u00a0GP clinic. Now\u00a0<em>question yourself why<\/em> &#8211; what&#8217;s making you make that call differently. Is convenience and expectation the driver or is it clinical need?<\/p>\n<ul>\n<li>Bob Phillips<\/li>\n<\/ul>\n<p><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>We (doctory, paediatric types) tend to pride ourselves on minimising distress to children and young people wherever possible. A couple of social media interactions over the last few days have made me re-question that &#8211; this one ..also responsibility to not create unnecessary fear. Not all blood tests go smoothly. Did the child really need [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/stg-blogs.bmj.com\/adc\/2016\/04\/08\/i-dont-want-that-needle-aka-do-fewer-things\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[2681],"tags":[],"class_list":["post-1276","post","type-post","status-publish","format-standard","hentry","category-practice-of-medicine"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts\/1276","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/comments?post=1276"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts\/1276\/revisions"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/media?parent=1276"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/categories?post=1276"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/tags?post=1276"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}