ENPC 2025 Practice Exam: Complete Study Guide for Pediatric Emergency Nursing

The selection of LET (lidocaine/epinephrine/tetracaine) as the best topical anesthesia for suturing a toddler's laceration is grounded in its efficacy and rapid onset of action. LET is a combination of lidocaine, which provides local anesthesia; epinephrine, which leads to vasoconstriction and prolongs the duration of anesthesia while minimizing bleeding; and tetracaine, which enhances the anesthetic effect. This combination is particularly beneficial for suturing because it not only numbs the area effectively but also reduces the risk of bleeding at the site, which is crucial when dealing with younger patients who may have thinner skin and smaller blood vessels.

The use of EMLA, while sometimes employed for minor procedures, often requires a longer application time (up to an hour) to achieve effective analgesia, and is less ideal for immediate procedures like suturing in a pediatric setting. LMX, although more convenient due to its easier application and higher lidocaine concentration, does not provide the vasoconstrictive properties of epinephrine, which can be valuable in minimizing bleeding during minor surgical interventions. Tetracaine alone, while effective, lacks the combined benefit of lidocaine and epinephrine that LET offers.

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