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<< Vascular Access in Pediatric Patients in the Emergency Department: Types of Access, Indications, and Complications

Pain Control

Pain control strategies are appealing to patients and their parents when IV access is needed, and they also serve to increase the likelihood of success of first-attempt placement.72

Topical Creams

A eutectic mixture of local anesthetics (EMLA® cream, 2.5% lidocaine, 2.5% prilocaine) is a topical anesthetic for use on intact skin that is widely available in most pediatric EDs. While there is evidence that patient comfort and successful IV placement are increased with the use of EMLA®, the time to appropriate analgesia ranges from 45 to 60 minutes.72,73 LMX® (formerly ELA-Max®), is a 4% lidocaine cream delivered via a liposomal vehicle that results in effective pain control for minor procedures in 30 minutes.73,74 While an occlusive dressing is often needed for EMLA® cream; this is not a requirement for LMX®.

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