[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Nursing](https://durgical.com/en/nursing/) › [Paediatric nursing](https://durgical.com/en/nursing/areas/pediatric/) › Preparing a child for procedures and surgery: therapeutic play, comfort holding and consent # Preparing a child for procedures and surgery: therapeutic play, comfort holding and consent - Safe practice Age-matched explanation, play with the equipment, a parent holding the child and the right consent make procedures safer and less frightening. Updated Nov 13, 2026 ## Key points - Therapeutic play: act the procedure out on a doll or toy, then let the child handle safe items and watch for fear. - Comfort holding: infants and children under 3 years held by the caregiver; from 3 years seated, preferably on the caregiver's lap. - The parent's job during the procedure is to comfort the child; the parent stays if allowed and wished. - Use neutral, honest words; avoid false reassurance such as 'it will only hurt for a second'. - Consent from the parent or legal representative per protocol, plus the child's age-appropriate agreement (assent). ## What it is Preparation lowers fear and pain and helps the child keep still, which makes the procedure safer and more accurate. It has three parts: explaining and rehearsing at the child's level, often through play with dolls and safe equipment; positioning the child in a comforting hold, usually on or by the parent, rather than pinning them down; and making sure the right person has consented and the child has been told and asked in words they understand. The same principles apply before surgery and before a blood test. ## What it requires - Explanation fitted to age and attention span (see the communication page). - Rehearsal of positions the procedure needs, for example curling up for a lumbar puncture. - A comforting position that keeps the child still and safe, with the least restraint needed. - Consent checked before the procedure, and the child informed and heard. ## Components - Dolls, toys and safe medical items (no needles or sharp objects). - A treatment room separate from the child's bed, with few people present. - The consent form and the institution's protocol for minors. - Distraction items: bubbles, books, songs, videos. ## How it is applied (and why) - Confirm the procedure, identity, consent and any fasting order — safety checks come before preparation. - Explain at the child's level and time it by age: just before for young children, ahead for older ones — timing controls anxiety. - Use a doll or toy to show the steps, bandage, injection or IV, then let the child play with safe items — play reveals fears you can correct. - Rehearse the position the procedure needs — practice makes keeping still easier. - Offer real choices, such as which arm or bandage colour — control lowers distress. - Hold a child under 3 in the caregiver's arms, or seat an older child on the caregiver's lap — holding calms and keeps the child still. - Use restraint only when needed for safety or an accurate result, as the protocol allows — the parent's role is to comfort. - Distract during the procedure and give one simple direction at a time — attention away from pain reduces it. - Afterwards, praise the effort, let the child express feelings, and record the procedure and how the child coped — it guides the next time. ## In nursing practice - Infants: preparation mainly helps the parent stay calm, which helps the baby; expect crying. - Ask that painful procedures not be done in the child's bed, and that few strangers come and go. - Ask whether the professional who has spent the most time with the child can be present. - Before surgery, the same preparation applies; for older children, videos of same-age peers having the procedure may help. - Avoid covering the child's face during the procedure. ## Common mistakes - Forgetting that the parent's role during the procedure is to comfort, not to restrain. - Preparing a preschooler days in advance, so fear builds. - Lying about pain or promising it will not hurt. - Skipping the child's assent because the parent has signed. - Doing the procedure in the bed or in a crowded room. ## Test yourself Think of the answer, then tap the question to see it. ## How should infants and children under 3 years be positioned for an injection? Held by the caregiver throughout; children from 3 years are seated, preferably on the caregiver's lap. ## What is therapeutic play before a procedure? Acting the procedure out on a doll or toy and letting the child handle safe equipment, while watching for fear. ## Why is 'it will only hurt for a second' discouraged? It is falsely reassuring; neutral, honest words keep the child's trust. ## Is the parent's signature enough before a procedure on a school-age child? The legal consent comes from the parent or representative, but the child should also be informed and asked for assent. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/nursing/preparing-a-child-for-procedures-and-surgery-therapeutic-play-comfort-holding-an/) ## Elsewhere in DurgiPedia - [Consent in minors: progressive autonomy in Colombian law](https://durgical.com/en/medical-ethics/consent-in-minors-progressive-autonomy-in-colombian-law/) ## Connections ## Related 3 - [The hospitalised child: stress by age, separation, the family and siblings](https://durgical.com/en/nursing/the-hospitalised-child-stress-by-age-separation-the-family-and-siblings/) - [Preoperative care: assessment, teaching, fasting, skin preparation and the checklist](https://durgical.com/en/nursing/preoperative-care-assessment-teaching-fasting-skin-preparation-and-the-checklist/) - [Physical restraints: a last resort and their safe use](https://durgical.com/en/nursing/physical-restraints-a-last-resort-and-their-safe-use/) [← All of nursing](https://durgical.com/en/nursing/) Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order. Sources: [Toddler test or procedure preparation (Medical Encyclopedia)](https://medlineplus.gov/ency/article/002056.htm) (MedlinePlus, U.S. National Library of Medicine, 2024); [School age test or procedure preparation (Medical Encyclopedia)](https://medlineplus.gov/ency/article/002058.htm) (MedlinePlus, U.S. National Library of Medicine, 2024); [Reducing pain at the time of vaccination: WHO position paper, September 2015 (Weekly Epidemiological Record 90(39):505–516)](https://www.who.int/publications/i/item/WER9039) (World Health Organization, 2015); [Blood sampling for research purposes in children: a practical guide to volume limits and minimisation strategies (European Journal of Pediatrics 185(11))](https://pmc.ncbi.nlm.nih.gov/articles/PMC13719829/) (European Journal of Pediatrics (open access, CC BY 4.0, PMC13719829), 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/nursing/preparing-a-child-for-procedures-and-surgery-therapeutic-play-comfort-holding-an/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/nursing/preparing-a-child-for-procedures-and-surgery-therapeutic-play-comfort-holding-an/