I rarely use an injectable anesthetic to suture a laceration on a child. Instead, I give the parent cotton swabs and topical XAP (xylocaine/adrenaline/pontocaine) and ask him or her to continually apply the anesthesia around and inside the laceration for a good 20 minutes. This numbs the area and avoids a scary needle and painful injection.—MELISSA SULLIVAN, CPNP, Charlotte, N.C. (185-7)

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