SLP Guidelines for the Use of Topical Anesthesia

Speech-Language Pathologists provide diagnostic and treatment services that may call for the use of topical anesthetics to complete certain diagnostic and/or treatment activities. For example, a patient may require the use of a topical anesthetic while undergoing a Fiberoptic Endoscopic Examination of Swallowing (FEES) procedure. 

It is the position of the Maryland Board of Examiners that the use of topical anesthetics by speech-language pathologists is within the Speech-Language Pathology Scope of Practice when necessary to complete such procedures.

The following Guidelines have been adopted by the Board for speech-language pathologists to consider when using topical anesthetics: 

1. The Speech Language Pathologist should check facility policies to ensure that they may apply a topical anesthetic in that facility.
2. The Speech Language Pathologist should undergo training in the use of topical   anesthetics that includes information about negative reactions and follow-up care. It is recommended that such training be documented in the Speech-Language Pathologist’s personnel file and be updated annually.
3. The Speech Language Pathologist should have an on-going relationship with an appropriate medical professional for information and referral purposes.
4. The Speech Language Pathologist should inform the patient of the need for the   use of a topical anesthetic and have informed consent forms signed as required by the facility.
5. It is recommended that the Speech Language Pathologist have access to an appropriate medical professional and/or facility in the event that an adverse reaction occurs.
6. Speech Language Pathologists should review relevant scope of practice documents, position statements, and related ethics issues prior to implementing the use of topical anesthetics in their practice.