MEDICATION ERRORS: Ethyl chloride spray: No cautery for alarm

July 2004 
Volume 34  Number 7
Pages 12 - 12
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  • Figure. No caption a...

    A nurse practitioner in an office setting prepared to lance a child's infected toe with electrical cautery. After spraying the area with ethyl chloride to numb it, she triggered the cautery device and the disposable pad under the child's foot went up in flames. The child's mother immediately pulled him away, and he wasn't burned.

    The nurse practitioner wasn't aware that ethyl chloride posed a fire hazard and should never be used with electrical cautery equipment. Ethyl chloride is heavier than air and the vapors may hug the ground, making distant ignition and flashback possible. Even static discharge could spark a fire.

    You can't always trust product labels to highlight flammability. Warnings may not be prominent or distinctive. Reevaluate the need for flammable products in your practice and advocate for safer alternatives, especially for topical anesthetics.

    Figure. No caption available. ...

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