The purpose of this handout is to explain when and how to use EMLA cream.
What is EMLA cream?
EMLA cream is a numbing cream that can be placed on skin to provide pain relief. It is often used to numb an area before placing an IV, drawing blood, or giving injections.
When do I use EMLA and how long does it last?
EMLA should be applied at least 1 hour before a needle stick. EMLA cream will begin to numb the site within 15 minutes after it is applied. When placed under a Tegaderm® dressing, it will take at least 60 minutes to begin working enough to provide pain relief. The greatest pain relief is seen 2-3 hours after it has been applied under the Tegaderm®. The numbness or pain relief will last for 1 to 2 hours after the cream is removed.
Be careful not to get the EMLA cream on your hands. If you do, wash them right away to be sure that your hands don’t become numb.
How do I apply EMLA cream?
EMLA should be applied to normal skin with no open areas. For young children, it is best to have two people help. One person holds the child; one applies the EMLA.
When using EMLA cream before a blood draw or IV placement
- Cover the backs of both hands and the inside of both elbows for an IV placement.
- Cover the inside of both elbows for drawing blood.
- First, look for large blue veins on the backs of the hands and inside of the elbows.
- Cover the largest blue veins with a large dollop of EMLA cream. Infants and small children will need less cream than larger children.
When using it before an injection into the skin or muscle
1. Cover the site with a large dollop of EMLA cream. Spread a thick layer over the skin surface; do not rub it in.
2. Take a Tegaderm® dressing and remove the center “cut out”. Your dressing should look like a window.
3. Peel the paper liner from the back of the dressing.
4. Cover the EMLA cream with the dressing. A thick layer of cream should be under it.
5. Smooth down the dressing edges to avoid leakage.
6. For persons who do not like Tegaderm® dressings or are sensitive to them, you can smooth a piece of plastic cling wrap over the EMLA cream and secure it in place with first-aid tape like Micropore® or Transpore®. Be sure to tape it down well. Be careful to avoid leakage.
What to look for
- Some patients notice blanching or redness of the skin. This effect is short term and may last for 1 to 2 hours. It will not interfere with the procedure.
- Other rare side effects are rash, swelling and itching at the site. If these occur, remove the dressing and wipe off the EMLA cream. Wash all the sites with soap and water.
- Do not apply EMLA near eyes or on open wounds.
- Do not use EMLA on children under 1 month of age.
- Keep extra EMLA out of reach of children.
- Once the cream has been put on the child, be sure the dressing stays in place and the child does not get EMLA in his eyes or mouth.
If you have further questions about EMLA, please talk with your doctor, nurse or pharmacist,
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 07/12/2011
Copyright © 07/12/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5706
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