Incision and drainage: Difference between revisions
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==Background== | |||
==Diagnosis== | |||
#May use US or needle aspiration | |||
#Check: Blood Glucose, IV drug use (XR r/o needle), consider HIV counseling/testing | |||
==Treatment== | |||
#Antibiotics | |||
##give if there is a large cellulitic component or fever | |||
##Need to cover staph and strep. | |||
#Update Tetanus | |||
===Incision & Drainage=== | |||
#Be sure to document if packing was placed in the wound | |||
#Anesthesia should be lidocaine or Marcaine without epinephrine | |||
#Most patients need some pain medicine prior to procedure | |||
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! | *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!!! | *Lido lasts 30-90 min, bupivicaine (.25%) max= 2mg/kg lasts 6-8 hr. Do NOT inject bupivicaine intravascularly b/c= refractory cardiac arrest!!! | ||
==Follow-up== | |||
Wound check in 1-2 days and wound care sheet | |||
==Source== | |||
[[Category:ID]] | |||
[[Category: | [[Category:Procedures]] | ||
Revision as of 15:30, 12 March 2011
Background
Diagnosis
- May use US or needle aspiration
- Check: Blood Glucose, IV drug use (XR r/o needle), consider HIV counseling/testing
Treatment
- Antibiotics
- give if there is a large cellulitic component or fever
- Need to cover staph and strep.
- Update Tetanus
Incision & Drainage
- Be sure to document if packing was placed in the wound
- Anesthesia should be lidocaine or Marcaine without epinephrine
- Most patients need some pain medicine prior to procedure
- 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!!!
Follow-up
Wound check in 1-2 days and wound care sheet