Pick the suture
28 y/o F female presents to the ED after incidentally cutting her left leg with a kitchen knife. There is no tendon, nerve, or vascular involvement in this clean, 6 cm laceration. What is the best suture type to use? When should she follow up for removal?
4-0 Ethilon. 7-10 days.
A 50 year old, 80 kg man, presents to the resuscitation bay in cardiac arrest. You decide to place a right proximal tibia IO for vasoactive drug administration.
Which IO needle will you use? (Pink, blue, yellow?)
Blue (> 40 kg)
You may infuse vasoactive drugs or transfuse blood through an IO. T/F?
True.
A 46-year-old farmer presents to the ED with a deep laceration to the right arm by a saw. He has a clean-appearing 6 cm laceration. What suture type and size would you use?
4-0 Vicryl interrupted deep sutures, followed by 4-0 Ethilon interrupted superficial sutures.
A 3 year old male, 15 kg, presents with vomiting and diarrhea for the last 3 days. Initial blood pressure is 65/32. Nurses are having difficulty obtaining access. You decide to place a proximal tibia IO. Which color do you use?
Pink (3-39kg)
Where would you insert a proximal tibia IO?
Two finger breadths below the patella and 1-2cm medial to the tibial tuberosity in adults
3 year old male presents to ED with 3 cm clean face laceration after falling and hitting a table. He is extremely irritable during the exam. What suture type and size would you use?
6-0 Fast absorbing gut
40 year old male, 160 kg, morbidly obese, was involved in a high speed MVC. BP is 75/30, pulse is 129. Vascular access is very difficult to obtain. You decide to place a proximal tibia IO. Which needle do you use?
Which IO drawn lab is unreliable?
a.) Creatinine
b.) Hgb
c.) WBC
d.) Glucose
c.) WBC
60 year old male presents with a mechanical fall and bleeding from mouth. Upon inspection of the oral cavity you notice an oozing, relatively large 3 cm gaping laceration to the buccal mucosa. What suture size and type would you use?
Chromic gut, 4-0 or 5-0. Consider penicillin prophylais.
24 year old man involved in high speed MVC presents with BP 62/39, pulse 137. Pelvic xray shows an unstable open book pelvic fracture. Vascular access is difficult to obtain. Where and which IO needle will you use? (location and color)
proximal humerus, yellow
Name two contraindications to placing an IO.
40 y/o F presents with cat bite to the right arm. There is a 2 cm puncture wound without foreign body contamination. What size and type of suture would you use?
None! Do not suture any contaminated wounds. Antibiotics and wound healing by primary intention.
All EZ-IO (pink, blue, yellow) are what size gauge?
15