In light of the recent JUCM article by Dr. Benjamin Barlow, Alan Ayers, and Monte Sandler, I wanted to talk about acuity degradation in urgent care. For me, it always circles back to lacerations. This articles shows that urgent cares are taking care of few lacerations than they did 10 years...

You will see me state this a lot. The solution to pollution is dilution. I didn't coin the phrase, but it is something that all of us need to know. A few years ago, when I was developing the IRIG-8 wound irrigation device, I had to research everything I could find about wound irrigation. High...

Working in the emergency department is sometimes referred to as "walking in a minefield with clown shoes on." The older I get, I see it more and more. As there are common things that can resemble more serious illness, the simple laceration can also hide more serious underlying problems. It...

Staplers-as with many things in the acute setting, price often trumps quality. Staplers for laceration management is no exception. We often are forced to use the cheap and wobbly 10 shot staplers. I have found these to be rather ineffective and I have to frequently remove staples and do them...

Visualization of the wound you are repairing is crucial. If you are struggling to see what you are repairing and whether or not the suture needle is in the right place, you are setting yourself up for problems.

It never fails, the treatment room doesn't have an overhead light or it's not...

I have to say that hunching over to repair a laceration is one thing I always end up regretting, getting old sucks. There are a few things you can do to make sure that you are protecting yourself when doing a laceration repair. Have the patient lie or sit so that the wound is close to you, don't...

Having a good pair of durable scissors or "trauma shears" will serve you well. If working in a busy ER, you will use these most every shift to remove clothing or bandages placed by EMS. They can also be used to cut fiberglass for splints. It never fails, you will need them when you don't have...

This may cause surgeons to have chest pain, but there is no need to wear sterile gloves when repairing a laceration. Let me say that again, you don't need sterile gloves to sew up a laceration. Think about it, the dirty skin just got cut by a dirty object. Using sterile gloves isn't going to make...

EM residents are expected to hit the ground running when it comes to seeing and managing patients with lacerations. It is one of the defining skills of emergency medicine and we take pride in our ability to repair lacerations. All interns will have done at least one EM rotation and possibly a...

We tend to practice based on what our attending physicians and residents told us. Some of these lessons we take as gospel and never challenge them. Some you are threatened with death if you even contemplate them! Contrary to the old mantra of "fingers, toes, penis, nose" when it comes to...

Urgent cares have flourished over the past 10 years. They stepped up to the plate and cared for scores of patients during the pandemic. Unfortunately, there is no formal residency program for "urgent care" and some UC clinicians may no thave had much training or experience with managing...

Primary care clinicians are the true engine of the healthcare system. Unfortunately, overly complex patients, 15 minute visits, prior authorizations, insurance hassles and administrative tasks eat away at the ability to work patients in for things such as lacerations.

Having worked in the ER and...