Difference between revisions of "Incision and drainage"
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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 | |
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| − | Be sure to document if packing was placed in the wound | ||
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*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! | ||
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*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