Xylocaine gel

[Bicycleboy]

I ask because I am curious.

I had an 84 year old pt who had recent knee surgery to reattach her left patella. She is progressing very well but the problem is a open blister on the the right heel that is causing her tremendous pain. She indicates that it hurts more then the knee injury ever did. She does not take anything stronger than APAP and is not able to take any opiates. She is also a diet controlled diabetic. My concern is that if she ambulates any less that she does now that she will stop progressing in her recovery.

I was thinking that xylocaine gel applied to the blister would help numb the pain for her so she could continue to ambulate. The thing is that I don't like to mess with diabetics and their feet and am not willing to experiment with something I know very little about. She has decent circulation to her feet, palpable pedal pulses, good cap refill and sensation and no history of neuropathy. I am also thinking that if it does work that numbing the pain too much will prevent the blister from healing because the pt will be walking more.

Right now she does not walk too much, just to the bathroom and such. Yes the doctor will know as soon as he decides to visit the floor so I am not looking for a prescription from allnurses, I am just wondering what your thoughts are on using xylocaine gel in this instance and if anyone can offer any insight.

[iluvivt, BSN, RN]

honestly,I would focus on healing that blister..then the walking would come....call the wound nurse if you have one...but I would not put a thing on it unless I was sure it was the standard of care

[tewdles, RN]

Is this a blister from friction caused by a shoe or similar? Or is it a blister because she was in bed for a couple days with pressure on her heel?

In any event, the first priority needs to be to protect this area from further injury.