Children can be traumatized when having to undergo a painful procedure. Whether it is insertion of an intravenous cannula or a routine intramuscular injection for immunization, for many children, exposure to these painful procedures can lead to major issues on subsequent exposures (Walco & Goldschneider, 2007, p.65). Therefore to reduce this distress and subsequent problems, topical anaesthetics have been used routinely for children in the emergency department as evidence shows that with the use of topical anaesthetics have the effect of reducing pain and distress during these painful procedures.
Two of the common topical anaesthetic agents used in emergency departments are amethocaine gel (or An Gel cream) and EMLA cream. Amethocaine gel is used exclusively in the general emergency department I work in for intravenous cannulation or venepuncture in children. Amethocaine gel is considered to be the more favourable choice in topical anaesthetics and replaced EMLA cream. In fact, the staff was given little choice but to use the Amethocaine gel as EMLA was completely removed from the department. As little education was given on Amethocaine gel when it was introduced, or why it is assumed amethocaine gel was better than EMLA, is was what precipitated further investigation into the introduction and use of this topical anaesthetic.
Evidence suggests that the benefit of Amethocaine gel has over EMLA is in that the time of application to needle time is significantly reduced (Lander, Weltman, & So, 2009, p.14). Newbery and Herd (2008, p.491) state that amethocaine’s mode of action could save time and therefore associated costs to the emergency department. This is significant as it decreases the delay in commencing treatment, which assists in decreasing patient stay in the emergency department, and also decreases stress to the child and care giver awaiting procedure.
Because of the lack of education with the introduction of Amethocaine gel into the
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