Field treatment for laceration

daedalus

daedalus

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Are there any systems out there that allow a paramedic to irrigate and than close a small laceration with steri-strips as in primary intention wound closure, and release the patient to follow up with there primary care provider? Pardon me if this thread should be placed with the wound irrigation thread we just had.

What, if any, are the drawbacks to allowing paramedics with special inservice from an ED MD to close small cuts with primary intention techniques?
 
I don't know any but realistically, I do not see a problem with a linear laceration that is clean and is superficial to be steri-stripped and or Dermabond. Yes, additional education would be mandated as well as F/U procedures.


R/r 911
 
Do you mean taking the certification class? Wouldn't that mean we have same qualifications (so why not?) Only thing is what about any potential underlying injury. Typically any significant lac is going to get a plain film to r/o fracture or anything out the ordinary (foreign matter) but then again, nowadays most pcp offices have x-ray and can do that on the follow-up. Being able to "close" a minor lac that does not require suture would significantly reduce that volume to the ED.

Drawbacks are probably more equipment needed on ambulance, increased on-scene time (treating on scene), increased liabilty when it comes to treat-and-release, less than professional EMTs who will not follow proper procedure (infection is often disregarded and not respected as it should be), more training needed by systems, and probably at least a dozen more Rid and Vent will take care of...

I think some areas could potentially make it work. I know of some companies that do regular details that it would possibly make sense to get properly trained and have clear guidlines and protocols to follow but would decrease transports and overall still do the right thing for the patient.
 
Additional equipment? Like a box of steristrips and durabond? It will reduce hospital load and therefore cut down on costs. As for onscene time, that would be acceptable if the patient were to be released.
 
Your private companies must be better than the ones I know...
 
I foresee this being one of the areas a Paramedic will perform. Homehealth Nurses do it all the time.

R/r 911
 
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