Incision and drainage: Difference between revisions
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Abscess / I & D: Anesthesia should be lidocaine or Marcaine without epinephrine.Most patients need some pain medicine prior to procedure. Check: Blood Glucose, IV drug use (XR r/o needle), consider HIV counseling/testing Follow-up : Wound check in 1-2 days and wound care sheet. Antibiotics – given if there is a large cellulitic component or fever. Need to cover staph and strep. Update Tetanus Be sure to document if packing was placed in the wound. *Toxic dose of Lidocaine is 5mg/kg with NO epi & 7 mg/kg w/ Epi! (toxic= ring in ears & se). Lido from code cart has no HCl that floor epi has, use HCO3 (1cc to 10cc Lido) to decr pain of floor lido d/t HCl! inject through wound edges NOT intact skin! *Lido lasts 30-90 min, bupivicaine (.25%) max= 2mg/kg lasts 6-8 hr. Do NOT inject bupivicaine intravascularly b/c= refractory cardiac arrest!!! | Abscess / I & D: | ||
Anesthesia should be lidocaine or Marcaine without epinephrine. | |||
Most patients need some pain medicine prior to procedure. | |||
Check: Blood Glucose, IV drug use (XR r/o needle), consider HIV counseling/testing | |||
Follow-up : Wound check in 1-2 days and wound care sheet. | |||
Antibiotics – given if there is a large cellulitic component or fever. Need to cover staph and strep. | |||
Update Tetanus | |||
Be sure to document if packing was placed in the wound. | |||
*Toxic dose of Lidocaine is 5mg/kg with NO epi & 7 mg/kg w/ Epi! (toxic= ring in ears & se). Lido from code cart has no HCl that floor epi has, use HCO3 (1cc to 10cc Lido) to decr pain of floor lido d/t HCl! inject through wound edges NOT intact skin! | |||
*Lido lasts 30-90 min, bupivicaine (.25%) max= 2mg/kg lasts 6-8 hr. Do NOT inject bupivicaine intravascularly b/c= refractory cardiac arrest!!! | |||
[[Category:ID]] | |||
Revision as of 22:34, 29 October 2010
Abscess / I & D:
Anesthesia should be lidocaine or Marcaine without epinephrine.
Most patients need some pain medicine prior to procedure.
Check: Blood Glucose, IV drug use (XR r/o needle), consider HIV counseling/testing
Follow-up : Wound check in 1-2 days and wound care sheet.
Antibiotics – given if there is a large cellulitic component or fever. Need to cover staph and strep.
Update Tetanus
Be sure to document if packing was placed in the wound.
- Toxic dose of Lidocaine is 5mg/kg with NO epi & 7 mg/kg w/ Epi! (toxic= ring in ears & se). Lido from code cart has no HCl that floor epi has, use HCO3 (1cc to 10cc Lido) to decr pain of floor lido d/t HCl! inject through wound edges NOT intact skin!
- Lido lasts 30-90 min, bupivicaine (.25%) max= 2mg/kg lasts 6-8 hr. Do NOT inject bupivicaine intravascularly b/c= refractory cardiac arrest!!!