title: Positive lidocaine toxicology screen after J-Tip for venipuncture.
abstract: Venipuncture is common in children, and topical anesthetics are often used to alleviate the pain of the procedure. The J-Tip (National Medical Products, Inc, Irvine, Calif) device has become popular as a rapid and effective means of delivering lidocaine noninvasively. We report a case of a positive lidocaine blood toxicology screen after the use of the J-Tip device in a child pre-venipuncture. A repeat toxicology screen obtained 1 hour later by venipuncture without J-Tip use was negative. This report serves to remind clinicians that topical anesthetics may interfere with toxicology assays, leading to unreliable toxicology results.
authors.affiliation: From the MassGeneral Hospital for Children, Harvard Medical School, Boston, MA.
authors.forename: Chetan
authors.initials: C
authors.lastname: Bhupali
authors.forename: Brian M
authors.initials: BM
authors.lastname: Cummings
authors.forename: Lois
authors.initials: L
authors.lastname: Parker
authors.forename: Robert
authors.initials: R
authors.lastname: Young
authors.forename: Natan
authors.initials: N
authors.lastname: Noviski
mesh_terms: D000779:Anesthetics, Local / Q000009:adverse effects* / Q000097:blood; D002675:Child, Preschool; D002998:Clonazepam / Q000097:blood / Q000506:poisoning*; D003244:Consciousness Disorders / Q000097:blood / Q000139:chemically induced*; D062787:Drug Overdose / Q000097:blood / Q000175:diagnosis*; D004636:Emergency Service, Hospital; D020234:Gait Ataxia / Q000097:blood / Q000139:chemically induced*; D006801:Humans; D007277:Injections, Jet / Q000009:adverse effects; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D008297:Male; D018962:Phlebotomy / Q000009:adverse effects; D015813:Substance Abuse Detection / Q000379:methods
chemical_list: D000779:Anesthetics, Local; D002998:Clonazepam; D008012:Lidocaine