When I had researched L-M-X4 (Topical Lidocaine Cream) this is in brief 
the differences that I found between L-M-X4 and EMLA Cream:

L-M-X4 is a 4% lidocaine cream provided with transparent dressing to 
cover (Note: Has no prilocaine which EMLA Cream has, hence no 
methemoglobinema reaction - sepaecially important for those infants and 
neonates)
L-M-X4 takes only 15-30 minutes to be effective (EMLA cream tkes 60 
minutes).
L-M-X4 is an over-the-counter medication - safe and non-invasive.


Pat Deisch MSN, RN
BryanLGH Medical Center



----- Original Message -----
From: "Gwen Irwin" <[EMAIL PROTECTED]>
Date: Wednesday, May 10, 2006 6:31 pm
Subject: Re: LMX4 (elamax - like emla)

> We use LMX4 (latest name for Elamax) all the time on pediatric 
> patients and do MST with the scalpel for the nick.  For PICC 
> insertions, we also leave it on as long as 1 1/2 - 2 hours.  (For 
> PIVs, less time.)  With the large barrier drape in place, the 
> children do not react at all to the stick or the scalpel.  We have 
> had babies sleep through their PICC insertions.  We have had 
> children verbalize nervousness about feeling anything, after we 
> are completely done and waiting for x-ray.  So, it works well.
> On the adult side of our PICC insertions, we don't have time to 
> wait for the LMX4 to work, so we use intradermal bacteriostatic 
> NS.  In rare cases, we will then also use intradermal lidocaine 
> (very high anxiety patient that has had a lot of pain with IV 
> attempts-just a gut feeling about which patients to use lidocaine 
> also).  The patients are very happy about their pain free PICC 
> insertion.Gwen Irwin
> 
>  ----- Original Message ----- 
>  From: Susan Fullana 
>  To: [EMAIL PROTECTED] ; [EMAIL PROTECTED] 
>  Sent: Wednesday, May 10, 2006 5:30 PM
>  Subject: elamax (like emla)
> 
> 
>  We use elamax on adults and in the past a few pedi patients. I 
> have used it for introducer placement and mst. If you leave it on 
> for a long period (I like 1-1 1/2 hours myself) I find it works 
> great. However, when I place with mst, I DO NOT use the scalpel. I 
> use the microintroducer-I take it apart and use the inside first---
> in and out a few times then, I put it back together and place the 
> entire introducer in. Pts seem to tolerate this well. Would not 
> even think of trying to use a scalpel with just elamax. Currently 
> only myself and one other nurse (she has just started mst) are 
> using mst to place PICCs. We are trying to get an ultrasound 
> machine and a new position for u/s PICC placement. I worked per 
> diem in another hospital where PICCs were only placed using MST 
> and ultrasound and we always used lidocaine only---never elamax. 
> Hope this helps.
> 
> 
>  Susan J. Fullana
begin:vcard
n:Deisch;Pat
fn:Pat Deisch
tel;pager:71-2582
tel;work:(402) 481-3617
org:BryanLGH Medical Center;
adr:;;1600 South 48th St;Lincoln;NE;68506;
version:2.1
email;internet:[EMAIL PROTECTED]
title:Clinial Nurse Specialist
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