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)
These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.