SS-
It shouldn't cause a problem if your young cutters would use it as directed, use it on the acceptable patients for this type medication, and watch carefully for cyanosis/low Po2 intially, etc.
In reviewing reported cases of methemoglobinemia, clinicians almost always (every case I read about) used multiple sprays of benzocaine and/or sprays of longer duration than recommended
"Spray in excess of two seconds is contraindicated"
Predisposing factors include age (infants under 6 months of age and older patients with cardiac problems may be sensitive to even low methemoglobin levels); the status of the area that is being sprayed (inflamed areas absorb more drug); concomitant use of other drugs which also have been implicated in causing methemoglobinemia; and the genetic make-up of the patient (due to altered hemoglobin, G6PD deficiency, or methemoglobin reductase enzyme deficiency).4,5
FWIW, Intravenous methylene blue is the treatment of
choice for methemoglobinemia. The typical initial dosage is 1 to 2 mg/kg intravenously; clinical improvement is typically noted within 15 to 30 minutes.
If in doubt, cut it out.... so that applies to pt comfort producing meds too?
HAHA
THANKS for the warning Sir. I treat a LOT of geriatric patients and use benzo gel daily...with no concerns. I do, however, use the hurricane spray for gagging patients and had not been properly educated to this phenom until you posted it. THANK YOU SIR.
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