TAC (tetracaine, adrenaline, cocaine): a controversial topical anesthetic for suture of skin lacerations.

TAC and half-strength TAC appear to be highly effective and convenient local anesthetic agents that offer an advantage over injected lidocaine in acceptance by children. The use of TAC is not without risk (cocaine toxicity, theft, and abuse). The decision of whether to use TAC is usually made by the physicians in the emergency department, in conjunction with the pharmacy and therapeutics committee. If it is used, 2 to 3 ml of the half-strength TAC may be the safest dose. The emergency nurse must carefully apply the TAC to minimize systemic absorption and must monitor the patient for signs of any toxic effects.