• Padma Gulur, Ari R Cohen, Lisa Watt, Mary E Lau, and Chadi El Saleeby.
• From the *Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital; †Harvard Medical School; and Departments of ‡Emergency Medicine, and §Pediatrics, Massachusetts General Hospital, Boston, MA.
• Pediatr Emerg Care. 2014 Nov 1;30(11):829-31.

AbstractWe report several cases in which pediatric patients at our institution have elevated lidocaine levels in toxicology screens after subcutaneous injection of lidocaine using a needle-free device. The purpose of this article is to report 4 cases in which pediatric patients have elevated lidocaine levels in toxicology screens after J-Tip administration. In particular, the article highlights 2 cases in which children younger than 3 years had lidocaine levels in the toxic range. Although the literature has reported the device to be effective with no significant untoward effects in children as young as 3 years, it seems that no information is available for children younger than 3 years. From a quality assurance/safety perspective, a summary is provided as our institutional response to concerns raised over what is typically thought to be a benign and beneficial intervention in children.

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