Drawing blood without a needle?
Discussion
To cut a long story short, my brother desperately needs a blood test because he has been loosing weight for the last six months. He can't have blood drawn in the normal way because he has severe learning difficulties and it would be impossible. The NHS has been f
king useless in organising this and has actually given up, so now there is no blood test planned. They seem content for him to rely on formula to try and boost his weight.
So, is there any alternative means of drawing enough blood for analysis?
king useless in organising this and has actually given up, so now there is no blood test planned. They seem content for him to rely on formula to try and boost his weight. So, is there any alternative means of drawing enough blood for analysis?
tablet sedation with some form of medical supervision, and this might only mean hanging around the nurses room at the GP, and something suitable to him like a benzodiazepine, or maybe ketamine
...plus Ametop or EMLA local anaesthetic cream over the proposed veins for blood taking, just so that even if he's not asleep/fully sedated you can still take the blood with minimal pain.
Aged 44 with LD, I'll admit it's difficult, but there's no such thing as impossible, you just have to think of a safe way round it.
The paediatricians have a million ways of getting round this with someone who has limited understanding of their circumstances
...plus Ametop or EMLA local anaesthetic cream over the proposed veins for blood taking, just so that even if he's not asleep/fully sedated you can still take the blood with minimal pain.
Aged 44 with LD, I'll admit it's difficult, but there's no such thing as impossible, you just have to think of a safe way round it.
The paediatricians have a million ways of getting round this with someone who has limited understanding of their circumstances
The_Doc said:
EMLA local anaesthetic cream over the proposed veins for blood taking, just so that even if he's not asleep/fully sedated you can still take the blood with minimal pain.
I tryed that when I was a kid cos I hated needles, and it really did jack squat. and i tryed it more than once as well.Melchett said:
Ruskie said:
Does he have capacity and/or understand the procedure?
No, he would not understand it at all. Any kind of restrain on him will cause him to pull away. It's an interesting dilemma from an ethical point of view and I don't mean that in a disrespectful way. If he doesn't have the capacity to make a decision then a decision should be taken in his best interests. In this case he needs bloods to be taken to stop him losing weight and to find a cause.
What about if you just went for it? 3/4 people and a competent doctor who could get the bloods off whilst he was restrained briefly. Obviously is is going to be distressing and unpleasant but acting in his best interest a minute of unpleasantness to get an end result.
Somewhere buried deep in your local NHS, there is very probably a learning disability nurse or nursing team. This is the person who can sort this stuff out. Otherwise, EMLA (numbing) cream on a few different potential sites and heavy-duty distraction of as many different sorts as possible, as an option worth trying before sedation?
Best wishes to you and your brother, OP. Hope everything is sorted ASAP.
Best wishes to you and your brother, OP. Hope everything is sorted ASAP.
Ruskie said:
Sedation/anaesthesia would also cause problems as the ways it's done , you need a cannula and a mask over your face.
It's an interesting dilemma from an ethical point of view and I don't mean that in a disrespectful way. If he doesn't have the capacity to make a decision then a decision should be taken in his best interests. In this case he needs bloods to be taken to stop him losing weight and to find a cause.
What about if you just went for it? 3/4 people and a competent doctor who could get the bloods off whilst he was restrained briefly. Obviously is is going to be distressing and unpleasant but acting in his best interest a minute of unpleasantness to get an end result.
The physical strength of a distressed person combined with the emotional damaged caused by restraining would be a serious risk. It's an interesting dilemma from an ethical point of view and I don't mean that in a disrespectful way. If he doesn't have the capacity to make a decision then a decision should be taken in his best interests. In this case he needs bloods to be taken to stop him losing weight and to find a cause.
What about if you just went for it? 3/4 people and a competent doctor who could get the bloods off whilst he was restrained briefly. Obviously is is going to be distressing and unpleasant but acting in his best interest a minute of unpleasantness to get an end result.
BlackVanDyke said:
Somewhere buried deep in your local NHS, there is very probably a learning disability nurse or nursing team. This is the person who can sort this stuff out. Otherwise, EMLA (numbing) cream on a few different potential sites and heavy-duty distraction of as many different sorts as possible, as an option worth trying before sedation?
Best wishes to you and your brother, OP. Hope everything is sorted ASAP.
yes to this.Best wishes to you and your brother, OP. Hope everything is sorted ASAP.
but as has been said EMLA is good, but not brilliant. Honestly Ametop is better and you should ask for it. It needs an hour at least.
Fozziebear said:
Ruskie said:
Sedation/anaesthesia would also cause problems as the ways it's done , you need a cannula and a mask over your face.
It's an interesting dilemma from an ethical point of view and I don't mean that in a disrespectful way. If he doesn't have the capacity to make a decision then a decision should be taken in his best interests. In this case he needs bloods to be taken to stop him losing weight and to find a cause.
What about if you just went for it? 3/4 people and a competent doctor who could get the bloods off whilst he was restrained briefly. Obviously is is going to be distressing and unpleasant but acting in his best interest a minute of unpleasantness to get an end result.
The physical strength of a distressed person combined with the emotional damaged caused by restraining would be a serious risk. It's an interesting dilemma from an ethical point of view and I don't mean that in a disrespectful way. If he doesn't have the capacity to make a decision then a decision should be taken in his best interests. In this case he needs bloods to be taken to stop him losing weight and to find a cause.
What about if you just went for it? 3/4 people and a competent doctor who could get the bloods off whilst he was restrained briefly. Obviously is is going to be distressing and unpleasant but acting in his best interest a minute of unpleasantness to get an end result.
the risks physical, practical and legal of this unneeded and ultimately unjustifable to a Court are very large ...
a known and significant risk of restraint of adults is Death or high Cervical Spine injury - there are numerous examples from Law Enforcement, Mental Health and learning disabilities practice
There is no assurance of getting the necessary samples ,when you restrain an acutely disturbed patient to sedate them by injection you are going to give them an Intra muscular injection NOT attempting to get a vein and keep a needle or cannula in the vein for a period between 15 seconds and couple of minutes depending on the vein.
the ultimate option with restraint and small kids is 'bruticaine' and then IM ketamine ... the problem is 'Bruticaine' ( physical restraint) is ineffective / far too risky for anyone over about three stone and 3 foot tall also it's an imprecise science in how much to give and then there;s the period between the needle 'away' and the drug actually kicking in
as for getting it done privately ? the private sector don't do the elderly, disabled or those with comorbidity ...
Mobile Chicane said:
The NHS will of course strenuously deny that any form of 'discrimination' exists, but I'd bet my bottom dollar the reason they're not exactly trying too hard to take a blood test, is the fact they'll have to act on the results.
whatever... given the number of procedures and tertiary admissions for those who you imply are treated as ;untermensch' that do go ahead i think you need some proof ... the issue in this scenario pure and simple is the risks of restraint ./ sedation / anaesthetising this chap
restraint alone is extremely dangerous
sedation or a gas induction of anaesthesia would require significant restraint and an IV induction if possible would be pointless as you've got the vascular access you need to take the bloods ...
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