Zempsky WT, Karasic RB. EMLA versus TAC for topical anesthesia of
extremity wounds in children. Ann Emerg Med. 1997;30:163-166.
Singer AJ, Stark MJ. LET versus EMLA for pretreating lacerations: a
randomized trial. Acad Emerg Med. 2001;8:223-230.
Park SW, Oh TS, Choi JW, et al. Topical EMLA Cream as a Pretreatment for
Facial Lacerations. Arch Plast Surg. 2015;42:28-33.
Regards to the list.
Rasha Sawaya wrote on 3/10/19 4:03 PM:
> Dear group,
> I have been asked to set up a protocol to use EMLA on pediatric wounds in
> our ER.
> I recall we stopped using it a decade ago and moved to LET in most US EDs i
> was working in. However i do not recall the reason (absorption, MetHb,
> other harm?)
> Here i only have EMLA available. The box says do not use on open wounds. I
> contacted the manufacturer who says the same, the reason being: not enough
> safety studies. A lit search using EMLA or an equivalent generic has shown
> nearly same efficacy and safety as LET for open wounds.
> I know about the methemoglobinemia reports in infants, and hence shying
> away from it for LPs.
> Can someone please give me a reason(s) why we shouldn't be using EMLA on
> open wounds? Or if you are using it, how is that reconciled with that fact
> that the label says do not.
> Thank you for the time,
> *Rasha Sawaya MD, FAAP, FAAEM*
> Pediatric Emergency Medicine/ Department of Emergency Medicine
> Assistant Professor of Clinical Emergency Medicine
> DEM Quality Director for Pediatrics
> Associate Program Director, Emergency Medicine Residency
> Director, DEM Medical Education Fellowship
> American University of Beirut Medical Center
> Beirut, Lebanon
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