Difference between revisions of "Incision and drainage"

(Created page with "<p class="MsoNormal">Abscess / I & D:</p> <p> </p> <p class="MsoNormal">Anesthesia should be lidocaine or Marcaine without epinephrine.</p> <p class="MsoNormal">Most pat...")
 
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<p class="MsoNormal">Abscess / I &amp; D:</p>
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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!!!
<p>&nbsp;</p>
 
<p class="MsoNormal">Anesthesia should be lidocaine or Marcaine without epinephrine.</p>
 
<p class="MsoNormal">Most patients need some pain medicine prior to procedure.</p>
 
<p>&nbsp;</p>
 
<p>Check: Blood Glucose, IV drug use (XR r/o needle), consider HIV counseling/testing</p>
 
<p class="MsoNormal"><span>&nbsp;</span></p>
 
<p class="MsoNormal">Follow-up : Wound check in 1-2 days and wound care sheet.</p>
 
<p class="MsoNormal"><span>&nbsp;</span></p>
 
<p class="MsoNormal">Antibiotics – given if there is a large cellulitic component or fever. Need to cover staph and strep.</p>
 
<p>&nbsp;</p>
 
<p class="MsoNormal">Update Tetanus</p>
 
<p class="MsoNormal"><span>&nbsp;</span></p>
 
<p class="MsoNormal">Be sure to document if packing was placed in the wound.</p>
 
<p>&nbsp;</p>
 
<p class="MsoNormal">*Toxic dose of Lidocaine is 5mg/kg with NO epi &amp; 7 mg/kg w/ Epi! (toxic= ring in ears &amp; 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!</p>
 
<p>&nbsp;</p>
 
<p class="MsoNormal">*Lido lasts 30-90 min, bupivicaine (.25%)<span>&nbsp;</span> max= 2mg/kg lasts 6-8 hr. Do NOT inject bupivicaine intravascularly b/c= refractory cardiac arrest!!!</p>
 

Revision as of 22:03, 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!!!