Difference between revisions of "Incision and drainage"

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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!!!
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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!!!
 +
 
 +
 
 +
 
 +
 
 +
[[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!!!