CHLOROFORM
INDICATIONS AND USAGE:
Ethyl Chloride is a vapocoolant intended for topical application to control pain
associated with minor surgical procedures (such as lancing boils, or incision
and drainage of small abscesses), athletic injuries, injections, and for
treatment of myofascial pain, restricted motion, and muscle spasm.
CONTRAINDICATIONS:
Ethyl Chloride is contraindicated in individuals with a history of
hypersensitivity to it. This product should not be used on patients having
vascular impairment of the extremities.
WARNINGS:
For external use only.
Skin absorption of Ethyl Chloride can occur; no cases of chronic poisoning have
been reported. Ethyl Chloride is known as a liver and kidney toxin; long term
exposure may cause liver or kidney damage.
Contents under pressure. Store in a cool place. Do not store above 120 deg F. Do
not store on or near high frequency ultrasound equipment. Store upright only.
PRECAUTIONS:
Inhalation of Ethyl Chloride should be avoided as it may produce narcotic and
general anesthetic effects, and may produce deep anesthesia or fatal coma with
respiratory or cardiac arrest. Ethyl Chloride is FLAMMABLE and should never be
used in the presence of an open flame, or electrical cautery equipment. When
used to produce local freezing of tissues, adjacent skin areas should be
protected by application of petrolatum. The thawing process may be painful, and
freezing may lower local resistance to infection and delay healing.
ADVERSE REACTIONS:
Cutaneous sensitization may occur, but appears to be extremely rare. Freezing
can occasionally alter pigmentation.
DOSAGE AND ADMINISTRATION:
To apply Ethyl Chloride from amber bottle with dispenseal valve, invert over the
treatment area approximately 12 inches (30 cm.) away from site of application.
Open dispenseal spring valve completely allowing Ethyl Chloride to flow in a
stream from the bottle.
1. TOPICAL ANESTHESIA IN MINOR SURGERY
The operative site should be cleansed with a suitable antiseptic. Apply
petrolatum to protect the adjacent area. Spray Ethyl Chloride for a few seconds
until the tissue becomes white. Avoid prolonged spraying of skin beyond this
state. The anesthetic action of Ethyl Chloride rarely lasts more than a few
seconds to a minute. Quickly swab operative site with antiseptic and promptly
make incision. Reapply as needed.
2. SPORTS INJURIES
The pain of bruises, contusions, abrasions, swelling, and minor sprains may be
controlled with Ethyl Chloride.
Spray affected area for a few seconds until the tissue begins to frost and turn
white. Avoid spraying of skin beyond this state. Use as you would ice. The
amount of cooling depends on the dosage. The smallest dose needed to produce the
desired effect should be used. Dosage varies with the nozzle size and duration
of application.
Determine the extent of injury (fracture, sprain, etc.). The anesthetic effect
of Ethyl Chloride rarely lasts more than a few seconds to a minute. This time
interval is usually sufficient to help reduce or relieve the initial trauma of
the injury.
3. FOR PRE-INJECTION ANESTHESIA
Prepare syringe and have it ready. Spray skin with Ethyl Chloride from a
distance of about 12 inches (30 cm.) continuously for 3 to 5 seconds; do not
frost skin. Swab skin with alcohol and quickly introduce needle with skin taut.
4. SPRAY AND STRETCH FOR MYOFASCIAL PAIN
Ethyl Chloride may be used as a counterirritant in the management of myofascial
pain, restricted motion, and muscle spasm. Clinical conditions that may respond
to Ethyl Chloride include low back pain (due to muscle spasm), acute stiff neck,
torticollis, acute bursitis of the shoulder, muscle spasm associated with
osteoarthritis, tight hamstring, sprained ankle, masseter muscle spasm, certain
types of headache, and referred pain due to irritated trigger point. Relief of
pain facilitates early mobilization in restoration of muscle function. The Spray
and Stretch is a therapeutic system which involves three stages: EVALUATION,
SPRAYING, and STRETCHING.
The therapeutic value of Spray and Stretch becomes most effective when the
practitioner has mastered all stages and applies them in the proper sequence.
I. EVALUATION
During the evaluation phase the cause of pain is determined as local spasm or an
irritated trigger point. The method of applying the spray to a muscle spasm
differs slightly from application to a trigger point. A trigger point is a deep
hypersensitive localized spot in a muscle which causes a referred pain pattern.
With trigger points the source of pain is seldom the site of the pain. A trigger
point may be detected by a snapping palpation over the muscle, causing the
muscle in which the irritated trigger point is situated to "jump".
II. SPRAYING
A. Patient should assume a comfortable position.
B. Take precautions to cover the patient's eyes, nose, mouth, if spraying near
face.
C. Hold bottle in an upside down position 12 to 18 inches (30 to 45 cm.) away
from the treatment surface allowing the jet stream of vapocoolant to meet the
skin at an acute angle to lessen the shock of impact.
D. The spray is directed in parallel sweeps .6 to .8 inches (1.5 to 2 cm.)
apart. The rate of spraying is approximately 4 inches/sec. (10 cm/sec.) and is
continued until the entire muscle has been covered. The number of sweeps is
determined by the size of the muscle. In the case of trigger point, the spray
should be applied over the trigger point, through and over the reference zone.
In case of muscle spasm, the spray should be applied from origin to insertion.
III. STRETCHING
During application of the spray, the muscle is passively stretched. Force is
gradually increased with successive sweeps, and the slack is smoothly taken up
as the muscle relaxes, establishing a new stretch length.
Reaching the full normal length of the muscle is necessary to completely
inactivate trigger points and relieve pain.
After rewarming, the procedure may be repeated as necessary. Moist heat should
be applied for 10 to 15 minutes following treatment. For lasting benefit, any
factors that perpetuate the trigger mechanism must be eliminated.
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