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Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow
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Topical anaesthesia in children: reducing the need for specialty referral

Gabrielle O'Connor1, Caitriona Mullarkey

  • 1Emergency Department, Mid-Western Regional Hospital, Limerick, Dublin, Ireland. gabbyoco@yahoo.com

European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine
|July 14, 2009
PubMed

Insights

Topical anesthetic gel significantly reduced referrals for pediatric wound care requiring general anesthesia. This approach improves patient safety and hospital resource management in the Emergency Department.

Area of Science:

  • Emergency Medicine
  • Pediatric Anesthesiology
  • Wound Management

Background:

  • Pediatric wound management in the Emergency Department (ED) can be stressful.
  • Lack of a pediatric sedation policy leads to referrals for general anesthesia for procedures like suturing.
  • Topical anesthetic gel (lidocaine, adrenaline, tetracaine - LAT) was explored as an alternative.

Purpose of the Study:

  • To evaluate the impact of introducing LAT gel on the number of children referred for general anesthesia.
  • To assess if LAT gel allows ED staff to manage wound procedures with non-pharmacological approaches.

Main Methods:

  • Retrospective review of ED records for children aged 14 years or less with wounds.
  • Data collected over an 8-month period before and after LAT gel implementation.
  • Comparison of referral rates for specialty review and general anesthesia between the two groups.

Main Results:

  • A total of 397 patients were reviewed (201 pre-LAT, 196 post-LAT).
  • Referrals for specialty review decreased from 19.4% pre-LAT to 9.7% post-LAT.
  • General anesthesia requirements dropped from 15.4% to 7.7% in the LAT group (P=0.018).

Conclusions:

  • Introduction of topical anesthetic gel (LAT) significantly reduced pediatric wound referrals for general anesthesia.
  • This intervention has positive implications for patient safety and efficient use of hospital resources.
  • LAT gel facilitates ED staff in managing wound procedures, reducing the need for specialized anesthetic teams.
Abstract

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