EMLA for cannulation? Why wait when a small bleb of lignocaine injected
through a small needle is relatively painless and makes cannulation
painless. It is something I was taught as a medical student and have used
ever since, like writing "please" after x-ray requests. Another advantage
of LA for drips is that a restless patient jumps on the local but stays
still for the cannulation, so chances of a first time placement are better.
And why do paramedics always put (frequently useless) cannulae in the ACF
thus ruining the site for later use. Do others find this a blasted
nuisance?
> -----Original Message-----
> From: Dunn Matthew Dr. (RJC) A & E - SwarkHosp-TR
> [SMTP:[log in to unmask]]
> Sent: Monday, September 06, 2004 9:40 AM
> To: [log in to unmask]
> Subject: Re: CRP
>
> > (donning bullet-proof underwear and not wanting to create
> > another painscore)
> >
> > How about the argument that it's better for the patient? ie
> > to only have
> > one venepuncture (for the IV and bloods) rather than 2 - ie
> > one for the ED
> > IV, one for the 'routine bloods' that the inpatient teams are
> > going to do
> > anyway.
>
>
> I agree with Adrian's argument that once the cannula is in and flushed,
> the
> bloods can be drawn at any time (how do you think they do repeated
> sampling
> on endocrinology units?). Also, there's a lot of patients have "routine
> bloods" done who don't need a cannula or emergency bloods (I know there is
> a
> reluctance to admit patients without a cannula in, but that doesn't mean
> it's needed); and in patients who need emergency bloods but not an
> immediate
> cannula, phlebotomy is a lot less painful than having a cannula in. Best
> thing for the patient is bloods drawn from the acf; EMLA on the cannula
> sites; cannula in once EMLA has worked.
> One of the problems with this idea of cannula= bloods= cannula is that the
> best place to draw blood from is the antecubital fossa, but conversely,
> although it's a pretty easy site to place a cannula in an emergency, it's
> a
> pretty poor site for a cannula (uncomfortable using arm, in a flexure, so
> prone to infection, movement makes it likely to dislodge; and if you have
> to
> withdraw it, then you've got a hole in a vein and can't place a cannula
> distal to it.
>
> Matt Dunn
> Warwick
>
>
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