Reply To: Smell intolerance

  • Jill Michel

    July 9, 2021 at 7:55 pm
    Hi! Similar to above, we used appropriate dose of ativan PO prior to arrival for toddlers, eventually the patients learn to cope better and don’t need it any more… for the older ones, who don’t tolerate the smells or tastes and not NPO, would let them pick a skittle, starburst or dumdum to suck on while caring for the line and offset the smells/tastes… good luck!

    Original Message:
    Sent: 7/9/2021 5:08:00 PM
    From: Michelle Oakley
    Subject: RE: Smell intolerance

    We had a patient with a similar experience. He would gag the minute I started peeling off his tegaderm and it got worse as I started to clean. 

    We started him on Lorazepam and his mom would give it to him prior to coming and it made a huge difference. After a few months of this, he actually doesn’t need it anymore. Not sure the safety in a 3year old though. 

     We also offered this patient some peppermint/orange essential oils from Elequil and his mom seemed to think that helped as well. We would put the essential oil sticker on his pillow or t shirt before accessing him. 

    Original Message:
    Sent: 7/9/2021 1:26:00 PM
    From: Angela Everson
    Subject: Smell intolerance

    I am hoping someone can help or confirm what I am doing is the best for a patient that has B-cell ALL age 3, and an extreme intolerance to smells. He has a angiodynamic port and currently cannot be cleaned with chlorohexidine or any cleaner with strong smell, flushed with NS, heparin, and sweats off his Tegaderm dressing. He has a recent Tegaderm skin tear from mom using Tegaderm over EMLA. He will scream and violently vomit when these smells are near him. I am currently using betadine to clean port area, D5 for flushes and 30 units of Heparin. Antiemetics are no benefit. I use a silicone dressing to help with his skin breakdown. When he is sedated for LP’s I flush him with NS and full 50 units of Heparin to reduce any fibrin sheaths and stickiness from D5. Any suggestions?

    Angela Everson, RN
    Pediatric Hem/Onc/infusion