Blood splatter

[SickEKMan]

Hi, I was just wondering how you all prevent blood and fluids from splattering in your face and all over the place while injecting local prior to doing a laceration repair or I&D.  This has been a real problem for me since day one.

[MediMike]

I'm having a little trouble understanding this question. Can you rephrase and explain what exactly it is you are doing?

[ventana]

Wear fluid shield mask every time to keep it out of your mouth eyes and nose 

 

spray is coming from pressure of injection and a track to outside world.  Lido does no good if not in skin so stop injection and reposition needle 

use tiny needles ie 25 or 27g needles. My preferred is a 27 x 1.5(or maybe 1.25). This allows me to get all around mostly with a single skin puncture 

cover up the abcess/wound with a gloved hand holding 4x4 above it(takes some practice

 

good luck.  Abscess fluid and blood tastes and smells bad so wear that fluid mask 

 

[kidpresentable]

23 minutes ago, ventana said:

Abscess fluid and blood tastes and smells bad

Nothing like a full body shudder to wake you up in the morning. Thanks, Vent

[Cideous]

I always try and inject with the needle pointing away from me, but what really works is I hold with off hand a few 4x4's and and create a "tent" with them over the injection site. It's a bit tricky as you have to see, but it can be done and generally reduces fluid in your face blowback by 90%.

[GetMeOuttaThisMess]

I always found the aroma from goo to be similar to the smell of napalm in the morning.  Never minded the smell for some strange reason.  Inject slowly, and avoid the 12 second NASCAR full tank fill method.

[PickleRick]

Local, shmocal.  Back in the good old days, we'd give 'em a swig of rum, and a leather strap to bite down on.  If amputating, they got two swigs.

[rev ronin]

I wear a pair of safety glasses with +3.0 diopter readers in them pretty constantly in clinic.  I don't usually get to do REALLY juicy abscesses or totally jagged lacs, so that works just fine for the occasional sebaceous cyst removal or skin biopsy.  Otherwise, I echo the full face shield advice above.

[SickEKMan]

Anyone have luck using topical analgesia (lidocaine gel, LET, etc.) for abscesses?

[PickleRick]

11 hours ago, SickEKMan said:

Anyone have luck using topical analgesia (lidocaine gel, LET, etc.) for abscesses?

Not much help, in my experience.  You really should be doing a field block for painful abscesses.  Simple and effective; you are injecting in a diamond shaped pattern outside the edges of the abscess.  Plenty of youtube videos out there if you need some guidance.

[ventana]

19 hours ago, SickEKMan said:

Anyone have luck using topical analgesia (lidocaine gel, LET, etc.) for abscesses?

nope, need to have broken skin for it to work

 

now having said that I will climb onto my soap box

clomp clomp clomp (three stairs to get on to box)

 

Topicals are GREAT!  Seriously great!

 

But don't be all like the bone headed interens, medical residents, and new surgical residents (they learn quick)  You gotta let the stuff stay on for a good 20-30 min - seriously it takes a long time - don't rush it just leave it on (soaking wet too)

 

I have used it in about every age - (needle phobia, mental health, fear of blood and the likes are all reasons to use it)

I even(gasp) used it on fingers (read somewhere the LET is okay for this)

 

More times then not (usually on new FMG medical residents) I suggested they wait 30 min but they are in there in 10min, not doing any lido injection "cause they have topical" and it feekin hurts the patient - I have had to leave the room "cause a PA can't correct a MD Resident....."

 

clomp clomp clomp - off soap box.....

[surgblumm]

If you needle is deep enough you will not be squirted by local. Simply placing a pad over the wound or abscess that you are holding and you will be fine. It's all a matter of proper technique.

[medic25]

On 1/12/2020 at 4:45 PM, ventana said:

 

But don't be all like the bone headed interens, medical residents, and new surgical residents (they learn quick)  You gotta let the stuff stay on for a good 20-30 min - seriously it takes a long time - don't rush it just leave it on (soaking wet too)

I've had to do the same education with topical lidocaine jelly for NG tubes with our nurses.  They'll use it as the lubricant for inserting the tube and think that the local is ineffective; once I told them to have the patient snort the jelly then wait 20 minutes, all of a sudden NG tubes are amazingly much more comfortable!