Amethocaine is not more successful than EMLA for first attempt intravenous cannulation in a children's emergency department.

Prevention strategies should concentrate on the hours after school finishes and should be tailored for Maori and Pacific Island communities.

Use of amethocaine in a mixed model in the CED could reduce cost and increase the proportion of children receiving topical anaesthetic during insertion of IVC. Trial registration number Australian New Zealand Clinical Trials Register ACTRN12606000409572.