Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Prior injection of local anaesthetic and the pain and success of intravenous cannulation.

Report by Ross Murphy Specialist Registrar Search checked by Simon Carley, Specialist Registrar A 45 year old woman attends the emergency department with cellulitis. You decide to admit her for intravenous antibiotics. She becomes agitated, distressed and tearful when you explain this to her. On questioning she reveals that she is afraid of the pain of intravenous cannulation. You wonder whether a prior injection of local anaesthetic would lessen the pain …