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> ... child needs to be not freaked out- reaction to having IV placed is a good guide-  then sedation better.

--> There is also the option of IM Ketamine, without the need for an IV, which is not only worrying to some patients, but also might not go in first attempt...

> We only use lidocaine and single cuff.

--> Brave.

Against our local rules. This is the scenario responsible for the adverse effects reports (and Prilocaine has fewer harmful effects).

> Double cuff in small arms is more difficult to apply - better one good big cuff.

--> I'd say the same, except with the word "worse" where you use "better". Double cuff is the way to avoid issues with cuff failure and I don't see why one would not opt for a cuff of the same width as the "big" one, but which has TWO bladders in parallel.

Not much of a debate for us, as I don't think we can get single cuffs.

If the limb is too short for the cuff, I'd go for sedation (which I prefer anyway).

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