Wednesday, August 13, 2008

Staples: That Was Easy

For someone who wants to go into emergency medicine, working in a busy ER is a great experience. Not only do I get to see interesting and bizarre injuries, but I'm also learning how to interact with patients and gaining some hands-on experience with bandaging and splinting wounds, removing sutures, and drawing blood. I've learned how to start a foley, started a few IVs, and assisted with procedures like central lines and lumbar punctures. But every once in a while, I get to do something new, like put eight staples into a patient's head.

I was finishing an EKG on a patient last night when one of the nurses asked me to help out a surgeon in the trauma room. An older gentleman had fallen at home, and came in with a large scalp laceration that started at the top of his head and moved down almost to the eyebrow. I walked in to find his scalp peeled back over his head, leaving a decently large chunk of his skull exposed. The gentleman's son looked a little squeamish, but the patient seemed pretty relaxed. The surgeon handed me a pair of sterile gloves, and asked me to clean out the clots that had formed on the skin flaps with some gauze while she cauterized the tiny bleeding vessels. After going through several blood-soaked 4x4s, she brought the flaps together and handed me the staple gun. She explained how to point and shoot, and I started moving my way along the lac with the gun, putting in eight staples total.

Maybe I can try my hand at intubation next?

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