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Saturday, July 15, 2017

Lidocaine

Emergency Physicians Monthly
EP Monthly - By Shenvi C & Serrano K - July 10, 2017
"Lidocaine is used routinely in the ED to numb up lacerations before repair and abscesses before I&D, or to perform digital blocks, hematoma blocks, nerve blocks, or intra-articular analgesia. Every medical student is taught how to infiltrate the skin with a thin needle, producing a blanching skin wheal. Lidocaine is also one of the ACLS 2015 antiarrhythmics for VF or pulseless VT. However, there are numerous other ways in which lidocaine can be used. The data supporting them is variable, and many of the uses are off-label. However, given the subjectivity inherent in the experience of pain, and the myriad mechanisms by which pain and noxious stimuli are sensed and transmitted, it is not surprising that there is some variability in the clinical response to lidocaine from patient to patient. Here we will outline a few of the interesting ways that lidocaine can be used. Personally, we have used it successfully basis for NG tube placement, urethral catheterization, in lower cervical muscular injections for headaches, atomized before nasal scope, and nebulized for cough or for ENT..."