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E-MED > PRINCIPLES OF WOUND CARE > Flashcards

PRINCIPLES OF WOUND CARE Flashcards

1
Q

Name some basic components of aseptic technique

A 
hygiene
use of PPE
use of sterile feild
opening and introducing packets w/out contamination
not touching non sterile items
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2
Q

3 components of a well managed wound

A

well vascularized (not dead or foreign stuff)-debrided
clean (sterile fluid)-irrigation
moist- dressed w/ impregnated layer, then dry layer

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3
Q

define a clean wound and its TX

A

Uninfected, operative wound, no infl., no Resp/GI/GU. Primarily closed, no abx.

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4
Q

define a clean-contaminated wound and its TX

A

Operative wound Rsp/GI/GU inv. in cntrld cndtns, debride, irrig, 1rst clos, Cefazolin/Cefotetan

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5
Q

define a contaminated wound and its TX

A

Trauma (exp. To FB), GI spillage, infl. Encountered. Debride, irrig, 2nd clos. Cefazolin/ofloxacin

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6
Q

define a dirty-infected wound

A

Old traumatic wounds, active infection. Debride, irrig, 2nd clos, Augmentin.

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7
Q

when is primary closure indicated?

A

• Primary: clean wound, deep enough to leave excess scar if not closed, suture->hairline scar

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8
Q

When is secondary closure indicated?

A

gaping, irregular wound, dirty >18hrs-

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9
Q

When is tertiary closure indicated?

A

wound that is greater than 18 hours. This is a judgement call for wounds that may be infected, but would ideally be closed for cosmetic or functional purposes. clean and debride, allow granulation and reassess in 4-5 days.

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10
Q

When is closure contraindicated

A

never close infected wounds: FB, contam, puncture, crush, abscess, sig. delay

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11
Q

what is stronger: synthetic or organic suture?

A

synthetic

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12
Q

what is more reactive: synthetic or organic suture?

A

organic

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13
Q

what has more tensile strength and is bigger: 1.0 or 10.0?

A

1.0

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14
Q

What size suture would you use on eyelids/face/penis?

A

7.0/6.0

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15
Q

What size suture would you use on low tension areas like parts of scalp, oral mucosa, abdomen or hand?

A

5.0

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16
Q

what size suture would you use on high tension parts of the scalp, the chest or foot?

A

4.0

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17
Q

what size suture would be appropriate for foot skin, deep in the abdomen or the back?

A

3.0

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18
Q

what size suture is used for chest tubes and GI tubes?

A

2.0

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19
Q

Name a strong and low reactive absorbable suture

A

PDS or Vicryl

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20
Q

Name a weak and high reactive absorbable suture

A

Gut type sutures (used in face and mouth)

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21
Q

Name a strong and low reactive non absorbable suture

A

Prolene or Nylon

22
Q

Name a weak and high reactive non absorbable suture

A

silk

23
Q

You just sutured a patient’s cheek, when can she have the sutures removed?

A

3-5 days

24
Q

You just sutured a hand laceration, when can your patient have the sutures removed?

A

7-10 days arms/scalp, 10-14 hands,trunk,legs and 14-21 for palms and soles.

25
Q

Your patient has to have surgical repair of his wrist what sort of anesthesia will block his entire arm? What are the minimum/ max times for this sort of anesthesia?

A

regional/bier block

min 30 minutes max 1.5-2 hours

26
Q

Your patient comes in with a giant abscess on his back and asks for anesthesia before your I&D. What’s a good option?

A

Local injection

27
Q

How does lidocaine toxicity present?

A 
metallic taste
tinnitus
lip tingling
agitation
seizure
arrythmia
urticaria 
anaphylaxis
28
Q

Your patient has a laceration on her index finger, what is a good option for anesthesia before you debride?

A

Digital block

29
Q

Your lidocaine says 1% on it what does this mean?

A

The concentration is based on kilograms per 100mL. 1% is 10mg/ml.

30
Q

What is the max dose for lidocaine 1%? w/ epi? How long does it last?

A

4mg/kg or 300mg or 30mL
7mg/kg or 500mg or 50 mL
lasts 1-2 hours 3 w/ epi
Same for mepivicaine

31
Q

When is mepivicaine contraindicated?

A

pregnancy

32
Q

What is the max dose for bupivicaine .25%?w/ epi? How long does it last?

A

2mg/kg=>175mg/70cc,
3mg/kg=> 225mg/90cc .
4-8 hours

33
Q

How long does topical EMLA need to be on to provide anesthesia to your kiddo before he gets a needle stick?

A

1 hour lasts up to 4 don’t use on broken skin.

34
Q

How long do lido, bupivicaine and mepivicaine take to start providing anesthesia?

A

about 5 minutes

35
Q

Name some examples of anaerobic infections

A

anaerobes displaced from GI or soil where they don’t belong….

  • dead/dying tissue
  • pneumonia
  • oral or pelvic infections
36
Q

What ABX work for anaerobic infections

A

metronidazole
clindamycin
G2 ceph like cefoxitin w/ anaerobic coverage

37
Q

Name some examples of G- infections

A

E. coli (UTI)
Klebsiela/Pseudomonas (Pneumonia, bloodstream)
N. Gonn (STD)

38
Q

What ABX work for G- infections

A
  • Fluoroquinalones (Cipro/levo)
  • TSM
  • Aminoglycoside (gentamycin)
  • 3rd Gen Ceph (ceftazadine, ceftriaxone)
39
Q

Name some examples of G+ infections

A
  • Staph(abscess and soft tissue, pneumo, etc),
  • strep (pneumo, URI, soft tissue)
  • enterococcus (UTI, diverticulitis, blood, intra abd.)
  • listeria (flu-like)
  • clostridium (enteritis C. perf, gas gangrene Cperf., diahrrea for C. diff)
40
Q

What ABX work for G+ infections

A

HAMRSA: Vanc,
CAMRSA: TMS. PCN’s, Ceph (1/2), Carbapenim, Macrolides, Tetracyclines

41
Q

Name 3 infections that affect the epidermis

A

erysipelas
impetigo
folliculitis

42
Q

Name two infections that affect the dermis

A

furuncle

carbuncle

43
Q

What infection exists b/t dermis and subQ

A

cellulitis

44
Q

what infection invades subQ and fascia

A

necrotizing fasciitis

45
Q

What infection invades muscle

A

gas gangrene

46
Q

DOC for impetigo, ulcer or lac?

A

mupirocin/ bactroban

47
Q

TX for simple abscess

A

I&D no ABX

48
Q

Complicated abscess/boil (cellulitis, const. sx, immunosup., area diff. to drain)

A

I&D Oral/IV Vanc/Linezolid/Clinda

49
Q

Non purulent (strep) cellulitis outpatient

A

Clinda/tms or doxy+cephalexin/b-lactam

50
Q

Purulent (staph) cellulitis outpatient

A

Clinda/TMS/Doxy/Linezolid

E-MED (9 decks)

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