Topical anaesthesia in children: reducing the need for specialty referral.

Hdl Handle:
http://hdl.handle.net/10147/206316
Title:
Topical anaesthesia in children: reducing the need for specialty referral.
Authors:
O'Connor, Gabrielle; Mullarkey, Caitriona
Affiliation:
Emergency Department, Mid-Western Regional Hospital, Limerick, Dublin, Ireland., gabbyoco@yahoo.com
Citation:
Eur J Emerg Med. 2010 Apr;17(2):97-100.
Journal:
European journal of emergency medicine : official journal of the European Society, for Emergency Medicine
Issue Date:
31-Jan-2012
URI:
http://hdl.handle.net/10147/206316
DOI:
10.1097/MEJ.0b013e32832f4387
PubMed ID:
19593151
Abstract:
OBJECTIVE: The management of wounds in children is stressful, not only for the child, but also for parents and staff. In our Emergency Department (ED), we currently do not have a paediatric sedation policy, and thus children requiring suturing, not amenable to distraction and infiltrative anaesthesia, are referred to specialty teams for general anaesthesia. We proposed that the introduction of a topical anaesthetic gel (lidocaine, adrenaline, tetracaine - LAT) might help to reduce the number of referrals, by allowing the ED staff to perform the procedures, in combination with nonpharmacological approaches. METHODS: We carried out a retrospective review of ED records of all children aged 14 years or less attending with wounds, over an 8-month period, from 01 May 2007 to 31 January 2008. RESULTS: Two hundred and one (50.6%) patients presented before the introduction of LAT gel, whereas 196 (49.3%) patients presented afterwards. A total of 39 (19.4%) patients were referred for specialty review pre-LAT, whereas only 19 (9.7%) patients were referred in the LAT group. Of these, 31 (15.4%) pre-LAT and 15 (7.7%) LAT group required general anaesthesia. There is a significant difference between these two groups, using Fischer's exact test, P=0.018. CONCLUSION: We have found that the introduction of topical anaesthetic gel in ED has significantly reduced the number of children with wounds referred to specialty teams for general anaesthesia. This has important implications for patient safety and hospital resources.
Language:
eng
MeSH:
*Administration, Topical; *Anesthesia, Local; Anesthetics, Local; Child; Child Welfare; Child, Preschool; Epinephrine/administration & dosage/therapeutic use; Female; Gatekeeping/*organization & administration; Humans; Lidocaine/administration & dosage/therapeutic use; Male; Medicine/*organization & administration; Pain/*drug therapy; Pediatrics; Retrospective Studies; Sympathomimetics/administration & dosage/therapeutic use; Wounds and Injuries/*drug therapy
ISSN:
1473-5695 (Electronic); 0969-9546 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorO'Connor, Gabrielleen_GB
dc.contributor.authorMullarkey, Caitrionaen_GB
dc.date.accessioned2012-01-31T16:47:59Z-
dc.date.available2012-01-31T16:47:59Z-
dc.date.issued2012-01-31T16:47:59Z-
dc.identifier.citationEur J Emerg Med. 2010 Apr;17(2):97-100.en_GB
dc.identifier.issn1473-5695 (Electronic)en_GB
dc.identifier.issn0969-9546 (Linking)en_GB
dc.identifier.pmid19593151en_GB
dc.identifier.doi10.1097/MEJ.0b013e32832f4387en_GB
dc.identifier.urihttp://hdl.handle.net/10147/206316-
dc.description.abstractOBJECTIVE: The management of wounds in children is stressful, not only for the child, but also for parents and staff. In our Emergency Department (ED), we currently do not have a paediatric sedation policy, and thus children requiring suturing, not amenable to distraction and infiltrative anaesthesia, are referred to specialty teams for general anaesthesia. We proposed that the introduction of a topical anaesthetic gel (lidocaine, adrenaline, tetracaine - LAT) might help to reduce the number of referrals, by allowing the ED staff to perform the procedures, in combination with nonpharmacological approaches. METHODS: We carried out a retrospective review of ED records of all children aged 14 years or less attending with wounds, over an 8-month period, from 01 May 2007 to 31 January 2008. RESULTS: Two hundred and one (50.6%) patients presented before the introduction of LAT gel, whereas 196 (49.3%) patients presented afterwards. A total of 39 (19.4%) patients were referred for specialty review pre-LAT, whereas only 19 (9.7%) patients were referred in the LAT group. Of these, 31 (15.4%) pre-LAT and 15 (7.7%) LAT group required general anaesthesia. There is a significant difference between these two groups, using Fischer's exact test, P=0.018. CONCLUSION: We have found that the introduction of topical anaesthetic gel in ED has significantly reduced the number of children with wounds referred to specialty teams for general anaesthesia. This has important implications for patient safety and hospital resources.en_GB
dc.language.isoengen_GB
dc.subject.mesh*Administration, Topicalen_GB
dc.subject.mesh*Anesthesia, Localen_GB
dc.subject.meshAnesthetics, Localen_GB
dc.subject.meshChilden_GB
dc.subject.meshChild Welfareen_GB
dc.subject.meshChild, Preschoolen_GB
dc.subject.meshEpinephrine/administration & dosage/therapeutic useen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshGatekeeping/*organization & administrationen_GB
dc.subject.meshHumansen_GB
dc.subject.meshLidocaine/administration & dosage/therapeutic useen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMedicine/*organization & administrationen_GB
dc.subject.meshPain/*drug therapyen_GB
dc.subject.meshPediatricsen_GB
dc.subject.meshRetrospective Studiesen_GB
dc.subject.meshSympathomimetics/administration & dosage/therapeutic useen_GB
dc.subject.meshWounds and Injuries/*drug therapyen_GB
dc.titleTopical anaesthesia in children: reducing the need for specialty referral.en_GB
dc.contributor.departmentEmergency Department, Mid-Western Regional Hospital, Limerick, Dublin, Ireland., gabbyoco@yahoo.comen_GB
dc.identifier.journalEuropean journal of emergency medicine : official journal of the European Society, for Emergency Medicineen_GB
dc.description.provinceMunster-
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