SplashIrrigation
High pressure irrigation of wounds is critical in reducing the rate of wound infection. There are a variety of commercial irrigation kits which include splash guards. If you are irrigating correctly and generating at least 8 PSI of pressure, some irrigation fluid should splash up and out of the wound. Be careful not to splash irrigation fluid in your eyes.

What if you don’t have a commercial irrigation setup? 

Trick of the Trade

Irrigate wound using an 18-gauge needle with a clear plastic cup as a shield

 
Irrigation1sm
 
Irrigation2sm
 

An alternative approach

Irrigate wound using an 18-gauge angiocatheter with a clear urine cup as a shield
 
Irrigation4sm

 

It makes me a little nervous to irrigate a wound with a needle (because of the unpredictable movements of patients). Also, we don’t have clear plastic cups in our ED. So, I rigged a similar setup using an 18-gauge angiocatheter and urine cup.

Use an 18-gauge needle to poke a tiny hole in the bottom of the urine cup. You may need to widen the hole a little by poking the plastic several times just adjacent to the initial hole.

Slide the 18-gauge angiocatheter into the hole and irrigate away!

 
Thanks to Dr. Gemma Morabito (Rome, Italy) for telling me about this great idea on her site Medicinadurgenza. The trick and video are by Dr. Ciro Paolillo of A Life At Risk blog fame!
Michelle Lin, MD
ALiEM Editor-in-Chief
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco
Michelle Lin, MD

@M_Lin

Professor of Emerg Med at UCSF-Zuckerberg San Francisco General. Founder of ALiEM @aliemteam #PostitPearls https://t.co/7v7cgJqNEn
Michelle Lin, MD