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Below is the version of the LET (or what we call XAP) preparation used at
St. John's in Springfield. It is extremely cheap to make and the viscous
xylocaine gives it a nice consistency. I have been using this formulation
for over 10 years in various ED's with an 85% success rate (personal guess).
The key is to leave it on the wound long enough for it to blanch out the
edges. At this point, anesthesia is usually reasonable. Jeff
 
 
 
 
The Pharmacy will be preparing a topical anesthetic solution for use in the
Emergency Room. It provides an effective method for providing anesthesia
when treating minor lacerations, while avoiding the toxicity possible with
cocaine found in TAC solution.
 
     The solution is prepared according to the formula below. An expiration
date of 30 days from manufacture is given to the product. Three CC oral
syringes of the XAP
Xylocaine, Adrenalin, Pontocaine) solution will be stocked in the ER PYXIS.
The syringes are kept in the Emergency room refrigerator and recorded out on
the PYXIS machine.
 
                                  Formula
 
      Tetracaine 2% 30 mL
      (Refrigerated)
 
      Epinephrine 1:1000 30 mL
      (30 mL vial for IV use)
 
      Lidocaine, Viscous 2% 60 mL
 
 
 
Mix items thoroughly into a uniform solution. Draw 3 ml into ORAL syringes
and cap.
     Assign a 30 day expiration date. Refrigerate.
 
 
 
 
At 08:21 PM 8/5/97 -0700, you wrote:
>Ah hah!!  We use Lidocaine/Adrenaline/Cocaine....... hence we call it
>LAC....MUST be applied with a q-tip or cotton ball and NO gauze or it is too
>patchy and then ineffective.  Had first time experience of it not working
>with my own son!  And I knew not to use the gauze, but the nurse talked me
>into holding the gauze over the cotton.  We get it from pharmacy in single
>unit doses.
>
>thanks!  Eleanor
>
>At 10:01 PM 8/5/97 -0500, you wrote:
>>Lidocaine/Epinephrine (adrenaline)/Tetracaine in a cellulose gel as
>>opposed to a liquid--"LET" = "LAT"
>>
>>                                    Terry
>>
>>
>>You wrote:
>>>
>>>At 01:35 PM 8/5/97 -0400, you wrote:
>>>>For those of you that use LET gel - in what quanity (unit dose) do
>>you
>>>>dispense it and how much do you typically use.  thanks.
>>>>
>>>>
>>>  What is LET gel?  It may have a different name up here.
>>>
>>>     Eleanor
>>>
>>>For more information, send mail to [log in to unmask] with the
>>message: info PED-EM-L
>>>The URL for the PED-EM-L Web Page is:
>>>  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html
>>>
>>
>>
>
>For more information, send mail to [log in to unmask] with the
message: info PED-EM-L
>The URL for the PED-EM-L Web Page is:
>  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html
>
>
 
Jeffrey A. Schwartz
Oak Park, IL
[log in to unmask]
 
For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html