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C.O.R.E. Promise

CORE promise logo

At St. Jude Children’s Research Hospital, the safety of your child is our top priority. The Safe and Sound: CORE Promise program helps ensure the safety of all children in our care. Experts across the hospital created the CORE Promise based on programs from other hospitals and feedback from members of our Patient Family Advisory Council. 

As part of CORE Promise, we offer comfort measures to your child during day-to-day medical procedures to help them cope. We use several methods to help ease your child’s pain and anxiety. 

CORE stands for: 

Comfort positioning: We may change the way your child sits or stands to help them feel safe and secure during needle sticks and other procedures.

One primary voice: We limit extra medical talk. This reduces confusion for your child and helps create a calm environment.

Reduce pain: We try to reduce your child’s pain when possible.

Every child, every time: We offer comfort measures for needle sticks and other procedures. We also ask you about the best ways to help your child feel safe and secure during tests and procedures. 

Below you will find suggestions on how to help your child feel more comfortable. Please ask your care team about using these strategies. 

CORE Promise recommendations by age group

About pain management

Pain management during needle sticks

  • Numbing cream requires at least 30–45 minutes to take effect. If your child needs labs to be drawn quickly, we suggest using another method to manage pain. Ask your nurse about strategies that work more quickly to reduce pain.

  • Cold spray is available to help reduce pain to the skin. Note: Cold spray is not recommended for children under age 4.

  • We suggest sucrose by mouth (up to 24 months), breastfeeding, or sucking on a pacifier for infants ages 0–12 months to reduce pain during needle sticks or other painful events. Sucrose can be given under the tongue or with a pacifier to encourage a sucking motion. Please ask your health care provider if you are interested in trying pain management strategies for your infant.

  • Some pain management agents cannot be used in certain circumstances. Please ask your health care provider for more details.

Pain management tips in Diagnostic Imaging

  • Your Diagnostic Imaging technologist can offer  Buzzy® and cold spray (age 4 and older) for pain management during needle sticks.

  • Sucrose and a pacifier or breastfeeding can be used for pain management for infants in Diagnostic Imaging. 

  • Diagnostic Imaging technologists cannot give lidocaine (numbing medicine). So, they cannot give numbing cream or J-tip (needle-free lidocaine) injections.

  • If your child prefers numbing cream or a needle-free lidocaine injection, please plan to apply numbing cream before their appointment or arrange to have the IV placed or port accessed before you arrive in Diagnostic Imaging. 

Support for children struggling with needle sticks

  • It is common for children to become fearful of needle sticks. Child life specialists and psychologists are trained to prepare and support your child as they cope with medical experiences. Please contact Child Life or ask your care team for a referral. 

Reducing stress during all types of care

  • You and your child can apply the principles of the Safe and Sound: CORE Promise to reduce distress during all types of medical care.

  • Child life specialists and psychologists are trained to prepare and support a child in coping with medical experiences. Please contact Child Life at 901-595-3020 or ask your care team for a referral. 

Distress reduction strategies available at most care centers

  • Many other hospitals also make formal or informal commitments to reduce distress during medical experiences. We encourage you and your child to ask for distress-reducing strategies wherever you get care. 

Learn more

Information from the Together ™ by St. Jude online resource

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