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ED > Wound ER > Flashcards

Wound ER Flashcards

1
Q

What is the most predictive factors for infection

A

Location, age, depth, configuration, and contamination

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2
Q

When you examine a wound what do you have to make sure is intact

A

Sensory (nerve), motor (msk), vascular

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3
Q

What do you do with an avulsion wound

A

cellulose wrap

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4
Q

What do you do with a superficial vessel

A

direct pressure +wound repair- if sutiring can use epi

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5
Q

What to do with an arterial bleed

A

apply direct pressure +call vascular surgery

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6
Q

If I have a FB in me what should you do first

A

Irrigate and probe the wound with forceps

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7
Q

Treat my wound

A

1) Clean
2) anesthetize
3) Irrigate- under pressure
4) Debridement of nonviable tissue
5) re-irrigate
6) suture/wound closure
7) antibiotics?

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8
Q

What antibiotics should you give with a wound

A

Keflex 500mg TID
MRSA?- bactrim DS ID for 10 days
Cat bite- augmentin

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9
Q

If I got a nail through my shoe what antibiotics should i get

A

anything that covers pseudomonas

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10
Q

How should you irrigate a wound

A

Under pressure

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11
Q

These are the strongest and most accurate methods of closure

A

Sutures

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12
Q

These are quick and easy method of closure

A

Staples

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13
Q

What is the most cost effective way of closing a wound

A

Adhesive tapes

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14
Q

This method of closing lasts for 5-10 days and is like glue

A

tissue adhesives

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15
Q

How far should tissue adhesive extend on either side of the wound edges

A

5-10mm

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16
Q

I have a facial lacerations what size suture should you use on me

A

6-0

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17
Q

I have a lip laceration what part do you suture up first…and what size suture do you use

A

vermillion border. 6-0

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18
Q

I have an intraoral laceration treat me!

A

4-0 absorbable, antibiotics and salt water gargles

19
Q

I have a laceration on trunk and extremities what size suture

A

4-0

20
Q

I have a laceration on my scalp what should you do

A

Staples or 3-0 to 4-0 sutures

21
Q

What is the classic suture for the ER

A

Simple interrupted

22
Q

I have a really deep cut, what suture shoudl you put in first to provide good tensile strength

A

deep dermal

23
Q

How long after an injury do you have to get sutures in your face

A

24 hrs

24
Q

How long after an injury do you have to get sutures on your body

A

12 hours

25
Q

Should lacerations on your hand be sutured

A

No- allow to heal by secondary intention

26
Q

For bit wounds what antibiotic should you give me

A

Amoxicilin-clavulanic acid (Augmentin)

27
Q

I have a hand injury who should I go see

A

Hand surgeon

28
Q

When should you admit me for a “Fight Bite” injury

A

Issue with compliance
Co morbid illness
Current evidence of infection
Joint/tendon involvement

29
Q

If I admit you what antibiotics should I give you

A

Ampicillin-sulbactam or cefoxtin

30
Q

I cut my extensor tendon is urgent repair essential

A

No- can wait a bit

31
Q

I cut my flexor tendon is urgent repair essential

A

YES- Scaring can occur if not

32
Q

What do you do while waiting for my flexor tendon lac repair

A

Antibiotics
Clean dry steril dressing
Splint- MCP flexed, PIP and DIP extended

33
Q

Tx my nail bed avulsion

A

Suture nail back on
Antibiotics
follow up

34
Q

What do you need to do for a subungaual hematoma

A

X-ray first to ensure no Fx

Clean, anesthesia, heated cautery tip, bacitracin, bandage

35
Q

What do you do with ring tourniquet syndrome

A

Cut the ring off or get it off somehow

36
Q

My wound isn’t healing. Why?

A

FB

37
Q

Should you get an X- ray of my FB

A

Yeah probably-

38
Q

What can you see on X- ray

A

Metal, bone, teeth, pencil, some plastics, gravel, snad, aluminum

39
Q

Is glass visible on x ray

A

Yup- 95%

40
Q

What types of things can you NOT see on x ray

A

Wood, thorns, some small fish bones

41
Q

What type of FBs should you give me antibiotics for after removal

A

soil-covered objects, teeth, anything dirty looking

42
Q

What is the only contraindication to tetanus toxoid

A

Hx of neurologic or severe systemic rxn

43
Q

What antibiotics for a FB

A

Augmentin, or Clinda for pen allergic

44
Q

I&D procedure

A

1) Consent
2) universal precautions
3) Prepare area
4) anesthesia
5) Use 11 or 15 blade
6) express pus
7) Insert hemostat into cavity
8) Break up loculations
9) Irrigate
10) pack loosley
11) pts should apply warm compresses
12) Schedule follow up
13) Antibiotics - Keflex TID for 10 days

ED (7 decks)

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