ED Procedures

Being Human…

EMKF

Procedures done in the Emergency Department are really painful. Research done in Kenya (READ MORE) showed that we’re doing loads of these but anecdotally the patients received minimal analgesia. Stop the SCREAMING…learn Procedural Sedation and Analgesia…it’s easy and more humane

Digital Blocks of the finger: One injection technique (Whetzel’s approach)

EMKF

The center of the palmer digital crease on the volar surface is identified as the injection site.

  1. The hand is cleaned appropriately with betadine or chlorhexidine and a 25 gauge needle is inserted at the palmar digital crease penetrating through the flexor tendons to the bone.
  2. The needle is then withdrawn slowly while applying gentle pressure to the plunger of the syringe. Once the needle is in the tendon sheath space, the lidocaine flows easily.
They recommend injecting 2-3 ml of lidocaine. It is also important to wait for the anesthetic to take full effect. I recommend waiting at least 7 to 10 minutes after the injection, then reassessing for satisfactory anesthesia.

Are you securing male catheters in the right place?

EMKF

To avoid necrosis at the urethral penile-scrotal junction caused by prolonged catheter pressure, it is recommended to secure urinary catheters to males’ abdomen. The catheter has to be positioned in a soft curve towards the femur and can be fixed with a securing device, tape, velcro™ or a pocket for the bag […] the same principles of stabilisation apply to suprapubic catheters.
(Geng 2012)