EMLA: The Secret to Pain Free Pokes

What Is EMLA?

EMLA is a topical mixture of equal amounts lidocaine (2.5%) and prilocaine (2.5%) that creates a dermal anesthetic. In mom speak: it’s the magic numbing cream.

The actual abbreviation stands for Eutectic Mixture of Local Anesthetics. That’s a mouthful… I’m sticking with “EMLA” and “magic cream”. EMLA was created specifically to prevent pain during IV placement, finger pokes, superficial surgical procedures and injections. It is also used in the tattoo, piercing, electrolysis and laser hair removal industries.

Is it Really Magic?

Um, yes. Hands down the best thing ever for routine pokes. I have tested this on myself and will never get a blood draw without it. It’s completely non-negiotiable for my kids. Ethan gets his subcutaneous port accessed regularly using EMLA to help numb the skin on top. Watch the video to the right to see how effective it is! I will keep this in my medicine toolbox at all times for: IV starts, blood draws, immunizations, finger pokes (blood sugar). We have even used it for nasty splinter removal.

Research: Is it Safe?

The research we have on EMLA is small but good! It has been found to reduce pain in all age groups, even infants with very minimal side effects. It does not interfere with the success of venipuncture. It is used routinely in Children’s Hospital around the world.

Ethan modeling proper application of EMLA on his port site with Press-n-Seal covering.

How to Use It

EMLA cream isn’t designed to be applied like a regular lotion and rubbed into the skin. You will get best results when you leave it as a glob and then cover it with a dressing. Try to leave it as thick on the skin as possible. I recommend covering with Press & Seal kitchen wrap (yes, really!). You can see a good dosage guide here.

Good pain relief is achieved 1 hour after application, reaches maximum at 2 to 3 hours, and persists for 1 to 2 hours after removal. Don’t fudge on the one hour minimum! Anyone trying to convince you that 20 minutes is enough, just isn’t telling the truth (even with heat).

If you are using it for blood draws or IV starts and they typically have a hard time finding a vein, it’s wise to apply it to several locations just in case.

Where to Get It

If you are in a clinical environment and need a poke, ask for EMLA cream. It is almost always available, even in small doctor’s offices. If you child has a lot of routine pokes, ask for a prescription so that you can keep some at home and apply it before going to visits. Or you can buy it online!

Restrictions & Contraindications

Just like any medication, there is a chance of an allergic reaction. It is suggested that the first time you try EMLA that you apply it at the clinical facility where the injection will be given. That way if there is a reaction you can be treated right away. It is contraindicated in patients who have a known sensitivity to anesthetics. It should be used with caution in infants, carefully managing the dosage so as not to create or exacerbate methemoglobinemia.

Alternatives

  • LMX cream: 4% lidocaine only. This is a little easier to get over the counter. We have not found it to be quite as effective for my son.
  • J-Tip anesthetic: Best used in emergency situations when you can’t wait 60 minutes. We have used it once and it helped Ethan quite a bit.
  • ShotBlocker: The only non-pharmacuetical device that I know of. We have never tried this.
  • Ethyl Chloride: A dermal anesthetic spray. We have never tried this.

photo credit: greenapple. via photopin cc

About Emily

Hi, my name is Emily. I’m a wife, mother, christian, momcologist, doula, writer, nerd, entrepreneur and dreamer. I like Apple products, chocolate, books, lists, being pregnant and the color purple. I fancy myself as a quirky combination of dreamy Anne Shirley and feisty Scarlett O’Hara but in a schizophrenic sort of way. Read on...

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