I haven't done ER for a while, but I was inclined to suture most pediatric
lac because it's difficult to keep hands, feet and mouth areas clean.
Suturing allows for washing after a day or so. Additionally, when you
anesthetize, you do a better exploration and cleansing of the wound.
I believe I used to give 5 cc of versad orally to calm the child (no head
trauma) and that seemed to work well. With the child already calmed down
(about 10-15 minutes afterwards), the infiltrating took just a monent.