Cellulitis/Abscess — Analgesia/Anxiolysis — Clinical Pathway: Emergency Department and Inpatient

Cellulitis/Abscess Clinical Pathway — Emergency Department and Inpatient

Analgesia/Anxiolysis

  • Include Child Life as needed
  • For large abscesses requiring complete incision and drainage, use ED Sedation Order Set and Procedural Sedation Pathway

Local Anesthesia

Topical Lidocaine 4% (LMX) cream
Intradermal Lidocaine 1% or buffered lidocaine 1% (with sodium bicarbonate)
0.45 mL/kg/dose (Max 30 mL)

Analgesia

PO Acetaminophen 15 mg/kg/dose (Max 650 mg)
Ibuprofen 10 mg/kg/dose (Max 600 mg)
Oxycodone 0.15 mg/kg/dose (Max 10 mg)
IN Fentanyl 1.5 mcg/kg/dose (Max 100 mcg)
IV Ketorolac 0.5 mg/kg (Max 30 mg)
Morphine 0.05-0.1 mg/kg/dose (Max 4 mg)
Fentanyl 1 mcg/kg/dose (Max 50 mcg)

Anxiolysis

PO Midazolam 0.5 mg/kg/dose (Max 15 mg)
IN Midazolam 0.4 mg/kg/dose (Max 10 mg)
IV Midazolam 0.035 mg/kg/dose (Max 2 mg)