Otolaryngology Procedures

Peritonsillar Abscesses

Peritonsillar Abscesses are the most common deep neck infection in adolescents and young adults. You will see them in grade schoolers as well. Learn about the diagnosis and management, including making the choice between needle aspiration versus wielding a scalpel for incision and drainage.


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Ungkanont K, Yellon RF, Weissman JL, et al. Head and neck space infections in infants and children. Otolaryngol Head Neck Surg 1995; 112:375.

Schraff S, McGinn JD, Derkay CS. Peritonsillar abscess in children: a 10-year review of diagnosis and management. Int J Pediatr Otorhinolaryngol 2001; 57:213.

Sumpter, R, Bridwell, R. emDOCs: Emergency Medicine @3AM: Peritonsillar Abscess. March 7, 2020. Accessed December 8, 2022.

Dental Procedures

Tongue Lacerations

Tongue lacerations are surprisingly common in the Emergency Department. Fortunately most of them don’t require any specific interventions. You just let them go and they heal on their own. Really. But if you do have to repair I offer advice in this brief episode.


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Resource from the British Dental Journal that has EXCELLENT pictures of healing tongue lacerations to share with patients and families.


Das UM, Gadicherla P1. Lacerated tongue injury in children. Int J Clin Pediatr Dent. 2008 Sep;1(1):39-41. PMID: 25206087.

Kazzi MG, Silverberg M. Pediatric tongue laceration repair using 2-octyl cyanoacrylate (dermabond(®)). J Emerg Med. 2013 Dec;45(6):846-8. PMID: 23827167.

Lamell CW, Fraone G, Casamassimo PS, Wilson S. Presenting characteristics and treatment outcomes for tongue lacerations in children. Pediatr Dent. 1999 Jan-Feb;21(1):34-8. PMID: 10029965.

Patel, A. Tongue lacerations. Br Dent J 204, 355 (2008).

Ud-din Z, Aslam M, Gull S. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Should minor mucosal tongue lacerations be sutured in children? Emerg Med J. 2007 Feb;24(2):123-4. PMID: 17251622.


Pain management for laceration repair in children

Laceration repair is one of the quintessential procedures that children undergo in Emergency Departments. Minimizing pain and anxiety for children is a much better idea than just holding them down and getting it done. This episode will teach you all about local anesthetics, when to use anxiolytics and procedural sedations s well as the considerable value of nonpharmacologic intervention – including Child Life Specialists.

This episode is a co-production of the Emergency Medical Services for Children Innovation and Improvement Center whose mission is to minimize morbidity and mortality of acutely ill and injured children across the emergency continuum. We have developed a series of pain focused episodes.

Other Episodes in the Series

The Pediatric EMS Podcast: Ouch-less Pediatrics

EM Pulse: Please Don’t Hurt Me!

EM Guidewire: Pediatric Pain Management – EMSC Improvement Project

PediaCast CME: Pediatric Pain… from the Family Perspective

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The Emergency Medical Services for Children Innovation and Improvement Center is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award (U07MC37471) totaling $3M with 0 percent financed with nongovernmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit

To learn more about the Emergency Medical Services for Children Innovation and Improvement Center visit


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EMSC IIC Pain Toolkit

Frank et al. How acidic is the lidocaine we are injecting, and how much bicarbonate should we add? Can J Plast Surg. 2012 Summer; 20(2): 71–73. PMCID: PMC3383550

Kennedy RM, Luhmann JD The “ouchless emergency department”. Getting closer: advances in decreasing distress during painful procedures in the emergency department. Pediatr Clin North Am. 1999;46(6):1215. 

Momsen OH et al. Neutralization of lidocaine-adrenaline. A simple method for less painful application of local anesthesia. Ugeskr Laeger. 2000 Aug 14;162(33):4391-4.

Resch K, Schilling C, Borchert BD, Klatzko M, Uden D. Topical anesthesia for pediatric lacerations: a randomized trial of lidocaine-epinephrine-tetracaine solution versus gel. Ann Emerg Med. 1998;32(6):693. 

Sinha M, Christopher NC, Fenn R, Reeves L. Evaluation of nonpharmacologic methods of pain and anxiety management for laceration repair in the pediatric emergency department. Pediatrics. 2006;117(4):1162.