No abstract

No abstract

No abstract

Background: Closure of facial lacerations in young children can be difficult under local anaesthetic (LA) in an emergency department (ED) setting. Sedation or general anaesthetic (GA) is often required to close lacerations safely and to a good surgical standard. Our hospital introduced local anaesthetic gel (LAT) in 2015 to reduce the need for paediatric admissions. Objectives: To ascertain the usefulness of LAT in reducing paediatric admissions. Methods: Data was collected prospectively of all children presenting to ED for input by oral and maxillofacial surgeon after the introduction of LAT. Data collected included age, aetiology, length and position of laceration, associated injuries and management. Use of LA, sedation, LAT and GA was also recorded. Findings: Over three months, 126 children attended ED. Lacerations accounted for 46% of attendances. LAT has been used to close one-third of these lacerations. 23 children (18% of all attendances) were admitted to hospital during this time, of which 40% were paediatric lacerations. The use of LAT was unsuccessful on two occasions and one patient required a GA for wound closure. All children admitted were under the age of five years. The majority of patients had been referred from local hospitals and had attended starved for theatre. Two patients had absolute indications for closure under GA -human bites and long lacerations. Conclusion: LAT has been an effective adjunct to management of paediatric facial lacerations. There is still work needed to ensure patients referred from local hospitals also have an opportunity to be managed without the need for GA.

No abstract