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ethyl chloride skin refrigerant spray

This is not a brand new topic...but I'd like to find out how many of you are using it...or know of its use...in some areas of your hospitals.  Do you have a policy permitting or prohibiting its use?  I've been asked to write such a policy, but need some back up info.  Has INS taken a stand on this?  I can't find it mentioned.

Thanks for any info.

Tanya Nauman RN, CRNI

I.V. Support

Eugene, OR

lynncrni
It was not included in the

It was not included in the 2006 INS standards because there were no studies at that time and because it is not a sterile product. I experienced this first hand a few days ago when I had fluid aspirated from my knee. I think it probably helped a little bit but certainly did not prevent all the pain. Of course this was different than venipuncture, but just my only experience with it.

Lynn Hadaway, M.Ed., RN, BC, CRNI

www.hadawayassociates.com

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Anne Marie Frey
I recently looked at one

I recently looked at one ethyl chloride product that our onco nurses were using to access ports...that product happens to be highly flammable, has an effect for a very short time, too short to clean the site adequately, and is not sterile, so in effect, you would have to clean the site, then spray on a non-sterile product, then access or stick the site...I was not gung ho about that procedure, so we decided to use LMX cream instead.  There are several other alternatives, such as a new product called Zingo, which is air pressure delivered lidocaine. I can attach a file FYI, but you should check with the manufacturer of whatever product you are looking at.                                                                         Anne Marie Frey RN, BSN, CRNI

Clinical Nurse Level Four

Vascular Access Service: I.V. Team

The Children's Hospital of Philadelphia

Anne Marie Frey RN, BSN, CRNI, VA-BC
Clinical Expert
Vascular Access Service: I.V. Team
The Children's Hospital of Philadelphia
[email protected]

Beverly Sharpe
Have you heard of or use the

Have you heard of or use the J-Tip?

 

mary ann ferrannini
 I eighty-sixed it out of
 I eighty-sixed it out of our policy since the lidocaine cream and sq/intardermal lidocaine worked so much better for our patients.
fizerjk
Please review the image in
Please review the image in the picture gallery of the ethyl chloride injury to a port-o-cath site, before you write your policy.

Jeffery Fizer RN, BSN

Shawn H.
Tanya, Gebauer's now has a

Tanya,

Gebauer's now has a product called the Pain Ease which is Nonflammable, non-ozone depleting and does not require special storage.  The new Pain Ease is NOT made of Ethyl Chloride.  The Pain Ease is safe, effective, works immediately, painless to administer, easy to use, and costs 80% lower than a topical anesthetic cream. 

There are many articles regarding the effectiveness of the use of vapocoolants in the Pediatric arena.  The most recent peer reivewed article titled "The effect of vapocoolant spray on pain due to intravenous cannulation in children: a randomized controlled trial" is published in the CMAJ dated July 1, 2008 and contains some great data.  The following link is an abstract. 

http://www.cmaj.ca/cgi/content/abstract/179/1/31

Please email me privately if you need any more information regarding the Gebauer's new Pain Ease Topical Anesthtic.

Shawn Hong
McCormick Medical

[email protected]

ladena rhoden
Years ago, we got rid of

Years ago, we got rid of ethyl chloride because 1. it is flammable 2. difficult to dose 

3. our patient population was very elderly (skin included) 4. I never liked the idea of cleaning a site and then spraying a chemical on it.  5. can't use it on a sterile site such as a port  6. very short duration.  7. I questioned whether you would carry the chemical into the vessel and contribute to a chemical phlebitis.

 Which brings me to my question - anybody have experience with this Pain Ease spray as far as phlebitis goes?  Still sounds as if you have to clean and then stick.

cubeca
pain ease

We recently started using another product called Pain Ease with Port-A-Cath access. It is a skin refrigerant but does not contain Ethyl Chloride. I 'd like to trial it for IV starts as well but there is limited literature available to support its use. Are any hospitals considering using this?

Thanks

Carol

Pam Rogers
Gebauer's Pain Ease, the idea

Gebauer's Pain Ease, the idea sounds good for port access at first but here is what I found out after looking into it further.

First this product is not sterile. Accessing a port is a sterile procedure. Therefore Pain Ease would have to be applied prior to prepping the site to maintain sterility.

Secondly the anesthetic property lasts one minute or less according to the manufacturer. 

At my hospital we prep with Chlorascrub and the product calls for a 30 second scrub with a 30 second dry time.

So unless there was a placebo effect, Pain Ease could not possibly be an effective anesthetic for port access using this prep method.

Pam

Pam Rogers CRNI

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