Lacerations of elderly patients or chronic corticosteroid users can be a challenge because they often have very thin skin. Sutures can tear through the fragile skin. Tissue adhesives may not adequately close the typically irregularly-edged laceration.
How do you repair these lacerations?
Do you just slap a band-aid on it?
Patients who sustain facial trauma often have swollen eyelids. They may be so swollen that it is impossible to pull back the eyelids for an ocular exam. You use one of our “Tricks of the Trade”ideas and attempt to “roll” the upper eyelid using the Q-tip trick (above).
Fresh blood on the face, however, makes the Q-tip a little slippery along the upper eyelid, preventing an adequate view of the eye itself.
Abscess drainage can be painful and time consuming in the ED. Can this article help? 1
Apply a topical anesthetic cream on skin abscesses prior to incision and drainage (I and D).
In this press-released article in American Journal of Emergency Medicine, the authors found that application of a topical 4% lidocaine cream (LMX 4) was associated with spontaneous cutaneous abscess drainage in children.
What is it about heat that makes everything feel better? Fireplace, hot tub, heat packs, electric blankets, and hot chocolate have got to be the best inventions EVER.
How can we apply this in Medicine?
At our department’s first annual UCSF High Risk Hawaii Conference 2 weeks ago, Dr. Rachel Chin taught about complications from all of the HIV drugs on the market now. It’s a virtual alphabet soup: EFV, TDF, FTC, oh my. How do you keep track of them all?
Does your Emergency Department have computerized spectrophotometric catheters to measure continuous central venous oxygen saturation (ScvO2) in early goal directed therapy (EGDT) for severe sepsis? That’s what was used in the original Rivers’ EGDT study.I’ve never even seen one before.
A health care worker hurried in to the ED after being poked with a needle.
‘It was an old 18G needle with dried blood’, she said. Her puncture had drawn blood. You discussed the very low risk of contacting HIV and the side effects of postexposure prophylaxis (PEP). She asked, ‘What does very low risk mean?’
Is there another way to covery risk for patients?