I had to get an arterial blood gas draw done earlier this year. Despite having an ultrasound which would make it easy to find the right spot in my wrist, the resident decided to “learn” on me by digging her large needle into my wrist and fishing around. After she failed her 5th or 6th attempt and my dilaudid couldn’t help me forget what was happening, the tech decided to “show” her how to do it and repeated the same experiment while tears rolled down my face. Finally the ICU NP brought in the ultrasound and got it done in one shot. Long story to say — we have lots of technology, but using it appropriately is the key!
A 27 or 30G insulin needle with some lidocaine (still often called lignocaine here in Australia ) is a nice addition to this procedure. I rarely omit it unless the patient is unconscious. If you inject the local anaesthetic under real time ultrasound, it can also serve as a seeker so you see if you’re off target with the 30G needle and adjust based on that information, which improves your success with the larger (commonly 22G) needle used to take the gas. Not unreasonable to request local anaesthetic, really - it is known to be a painful procedure.
This is how I became needle phobic and hospital phobic till I was an adult and I overcame it. I remember just the smell of hospitals would send me into severe anxiety.
