Lacerations Flashcards
Top 6 History Questions one should ask:
When injury occurred Cause of injury Where the injury occurred (i.e. farm, etc) Other injuries Medications Other health problems
Top 7 Wound Complications
Infection Irregular closure Dehiscence Contact dermatitis Suture reaction Keloid formation Necrosis
In examining a wound, what are the top 8 physical exam components?
Depth Edges Circulation Nerve Injury Tendon injury Foreign body Fracture Orientation
Top 7 methods of closing a wound
Nonabsorbable Staples Glue Tape Absorbable sutures Secondary closure Hair tie
What would you do with a bleeding wound?
Direct pressure
Contraindications to primary wound closure
infected/inflammed
Serious crush injuries
Too long after injury (face w/in 24 hrs, body w/in 18) - 6 preferred
TAC
Tetracaine epinephrine cocaine - traditional but has cocaine in it
LET
lidocaine, epinephrine, tetracaine -safer
EMLA
eutectic mixture of local anesthetic - requires occlusion, 90 minutes to work
Most likely to cause allergic reaction?
Lidocain, mepivicaine, procainamide, bupivacaine
procainamide (also for arrythmia) - an ester
how to inject local anesthetic
through sides of wound edges into adjacent tissue
buffered
slowly
small needles
Narcotics
Parenteral - morphine, hydromorphone, fentanyl
Oral - hydrocodone and oxycodone
Benzodiazepine
Lorazepam (ativan), medazolam (versed) - amestic
Dissociative
Ketamine (LSD-like)
Three common suture techniques
interrupted, continuous, subcuticular
