Lidocaine prior to IV start? - page 4

by WVUturtle514

50,162 Views | 128 Comments

I am in a front-loaded program and will be starting full-time clinicals in August (thank goodness), but this semester we have had several "observation days." During my last obs day I was with one of my professors who asked me to... Read More


  1. 0
    Quote from yoga crna
    I am very curious about your allergy to lidocaine. True allergies to amide local anesthetics, such as lidocaine are very rare. I did a Medline search and found no references of such an allergy. Could you have had a reaction to the epinephrine in local used in dentistry? Some people get a CNS excitation from an overdose, but this is not an allergy. I would love to have more information.

    Never too old to learn new information.

    YogaCRNA
    My "allergy" to lido is the fact that I hate it. I hate that small needle. It hurts and I'm not talking about the lido sting. I think a small needle hurts more than the bigger one.

    Remember I use 15's all the time. Well once in a while 17's. We discourage the use of lido because it causes scar tissue around a graft or fistula.

    Yes, I know we stick them three times a week.

    Drug addicts in the back alley's don't use lido.

    I hate needles just the thought of getting stuck scares me. So one is enough.

    Interestingly, I've never even been offered it at any Red Cross blood drive.

    What gauge needle to they use. 16 or 14?

    We got rid of lido on the M/S floor because it can be a dangerous drug to have sitting around.

    JMHO.
  2. 0
    I just had my first IV insert with lido when I had my third baby 3 months ago and It was a million times easierfor me. I am a hard start and this made all the difference. I will never insert an IV in one of my patients with out lido again. If I can prevent unesessary pain I should. I also have re thought my position on topical lido for catheter insertion as well. When we know better we do better.
  3. 0
    Quote from ahsitters
    I just had my first IV insert with lido when I had my third baby 3 months ago and It was a million times easierfor me. I am a hard start and this made all the difference. I will never insert an IV in one of my patients with out lido again. If I can prevent unesessary pain I should. I also have re thought my position on topical lido for catheter insertion as well. When we know better we do better.
    What catheter insertion are you talking about?

    Central catheter????
  4. 0
    I always use lido on pts in the OR as well as when i get called to the floor to do a difficult stick. The pts always appreciate the lido. I routinely get asked is done already? Only because the pt did not feel the bigger needle going in. I will admit that it does get a little bit of getting use to at first.
  5. 0
    Quote from LisaRn21
    I work in peds and this is not a common practice... There are some kids that we use it on but very rarely do we.

    ELMAX acts as a vasoconstrictor and if we are putting it on the site it acctually makes it harder to get an IV in the kids... and when we have babies and such they already have tiny veins I know it sounds evil to enforce the pain... but most times it does more harm than not.
    I dont know of any vasoconstirctor properties for EMLA (lidocaine and prilocaine are the active ingredients, correct?), if anything I would think it might vasodilate, like someone else said, similar to a minisympathectomy. The only local anesthetic that has vasoconstriction is cocaine. Is ELMAX different from EMLA cream, just a misspelling (someone else mentioned LMAX), or a brand name?
  6. 0
    ELA-MAX or (LMX) is similar to EMLA but it is 4% Lidocaine plain (no prilocaine-so it is safer becuase of the decreased risk of methemoglobinemia in little ones). It is supposed to work faster than EMLA cream (about 15 minutes vs 30 minutes). I have used it on myself and my son and it works very well. No, it does not vasoconstrict, but it does blanch the skin a little. I heard you can now get it over the counter.
  7. 0
    Quote from NephroBSN
    My "allergy" to lido is the fact that I hate it. I hate that small needle. It hurts and I'm not talking about the lido sting. I think a small needle hurts more than the bigger one.
    Well then that's not quite an 'allergy' is it? That's preference and any quality healthcare provider should honor such a request as to not use SQ lidocaine if you so state so.

    This falls under the constant allergies I see when doing pre-ops (that the juniors should have done the day before, but that is another story) and at least keeps me smiling throughout the day....

    Me: Do you have any food or drug allergies?
    Pt: I'm allergic to benadryl.
    Me: What does that do to you?
    Pt: It makes me sleepy. And I'm allergic to versed. Makes me sleepy also.

    Here's the world's best one I've heard yet..
    Me: Any allergies?
    Pt: I'm allergic to fentanyl.
    Me: Are you serious?
    Pt: Yes, it gives me diarrhea.
    Me: And who told you this?
    Pt: Nurse tech did.
  8. 0
    Quote from NephroBSN
    What catheter insertion are you talking about?

    Central catheter????
    Pretty much all routine IV's are catheters. Very few people use butterflies any more, and even those are available as a catheter.
  9. 0
    It seems I caused some confusion.I ment lidocain jelly with urinary catherter insertion as well as using lido with iv insertion.
  10. 0
    Out of curiousity, rn29306...what were you talking about with the Juniors doing the preops?

    And yes, use intradermal Lido with all awake ALs and IVs.


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