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25 Cards in this Set
- Front
- Back
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goal of wound care
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restoration of function
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main types of skin trauma
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blunt trauma: split or crush inj., + swelling, high infx risk
sharp trauma: clean edges, low infx risk bite injury |
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Risk of infection is highest in [blunt, sharp, bite]
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bite
(blunt is second) |
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Higher risk of infection in wound over ? hours old
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ten
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Penetrating injuries should have primary closure within what time frame?
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8-12 hours after injury
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Patient has a laceration. What past medical history should you check for?
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DM
PVD malnutrition obesity chronic renal failure connective tissue dz immunosuppression (steroids, chemo) ask about prior healing of wounds |
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severe pain in a lacertation might indicate ?
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underlying fracture
foreign bodies compartment syndrome necrotizing fasciitis |
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Examination of wound must be done under what conditions?
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bloodless field
(bp cuff) |
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What 2 point discrimination should you clear for fingers and palm?
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2-5 mm fingers
7-12 mm palm |
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In hand tendon can have what percent of tear without showing sx on exam?
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70%!!
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What is a Tuft's fracture?
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crush injury of distal phalanx
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What foreign body material is not visualized on XR?
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wood, plastic, some types of glass
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Anesthesia for wound repair: LET topical
--what is it --how applied --onset |
lidocaine 4%
epinephrine 1:2000 tetracaine 0.4% cotton ball on wound 10-30 minutes, can be applied in waiting room |
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Anesthesia: EMLA cream topical
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2.5 % lidocaine and prilocaine
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Lidocaine dose for injected anesthesia in wound repair
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0.5-2% mg/ kg --watch weight of patients. Caution in kids!
5% is toxic, a little higher with epinephrine |
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Best anesthetic for a wound that will take a long time to suture
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bupivicaine (markaine) 2 mg/kg
4-8 h duration, 8-16 with epi |
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Mnemonic: amides vs esters in anesthetics
(use other class if there is an allergy) |
amides have TWO i's in name
lidocaine bupivicaine mepivicaine esters have one i in name procaine tetracaine benzocaine cocaine |
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T/F surgical adhesives cause more deformity in wound healing than sutures
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false
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#1 thing you can do to prevent infection of a wound
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debridement
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What must you do in order to use betadyne to irrigate wound?
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make sure it's diluted to 1% solution
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Wound closure: distinguish
primary secondary tertiary |
primary: suture closure
secondary: leave open, heal by granulation tertiary: come back in 4 days, suture |
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Describe wound eversion technique
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Base of suture should be wide or wider than the top of the suture loop
Not a V but a horseshoe |
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When do suture marks develop?
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If sutures are left too long or there is too much extrinsic or intrinsic tension
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two best types of sutures for EM
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monofilament and synthetic
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type of suture needle for skin?
mucosa? |
skin = cutting
mucosa = tapered |
