[alyca]

My name is Alyca, and I am a trauma/orthopedics nurse at a level 1 trauma center in Seattle, Washington. We deal with everything from hand replants to skin grafts, external fixators, halos, leech therapy, you name it-if it is broke, we fix it! I have almost exactly 2.5 years experience working as an RN, and I generally love my job.

[Shed13911]

Welcome to the BB. Your job certainly sounds interesting!

[LesJenRN]

Originally Posted by alyca

My name is Alyca, and I am a trauma/orthopedics nurse at a level 1 trauma center in Seattle, Washington. We deal with everything from hand replants to skin grafts, external fixators, halos, leech therapy, you name it-if it is broke, we fix it! I have almost exactly 2.5 years experience working as an RN, and I generally love my job.

Welcome Alyca! Okay, the leech therapy thing would really gag me...... I have been working in critical care for 9 years now and am headed over your way next month! I am excited to work there after being in some pretty low key hospitals. You'll enjoy this site. Lots of great discussion, educational, humerous and sometimes emotional...

[alyca]

Originally Posted by LesJenRN

Welcome Alyca! Okay, the leech therapy thing would really gag me...... I have been working in critical care for 9 years now and am headed over your way next month! I am excited to work there after being in some pretty low key hospitals. You'll enjoy this site. Lots of great discussion, educational, humerous and sometimes emotional...

Actually, the leeches are kinda cool. It sucks (!) if they are ordered Q 1 hour, but when they are not quite as frequent they are interesting to deal with. They are green and red and yellow and kinda cool to look at.

Alyca

[LesJenRN]

Originally Posted by alyca

Actually, the leeches are kinda cool. It sucks (!) if they are ordered Q 1 hour, but when they are not quite as frequent they are interesting to deal with. They are green and red and yellow and kinda cool to look at.

Alyca

How do the patient's respond to those little suckers??

[manna]

Welcome to allnurses! I've always wanted to visit Seattle.

[traumaRUs]

All I could think about regarding head replants was exchanging people's head - like some sci-fi movie gone bad!!! We have an orthopod (hand surgeon) that uses leeches. He sent one of his pts into the ER one night because the pt said the dressing was too tight - so I start gabbing with the pt as I unwrap the dressing. I get down to the bottom few layers and the pt speaks up and tells me not to dislodge the leeches!!! Yuck, yuck, yuck! I hastily dropped the dressing and never went into the room again. Eeek!!

[alyca]

We attach a leech to the severed part for 30-45 minutes, depending on how long it takes them to fill up. They fall off on their own when they are full. Most patients are so happy to have their finger/thumb put back on that they love the leeches. Since there is generally some extensive or complete nerve damage, they can't feel the leeches work, and they know that it can mean the difference between having a finger or losing it. THat tends to make patients good fans of leeches. A few can't look at them, and need to have them covered up with a towel or something so they can't see them, but that is not so common.

The point of the leeches is that severed digits tend to have a lot of venous congestion after they are reattached, which is a common reason why replants fail. Leeches remove some of that excess blood, and also secrete a blood thinning chemical in their saliva that keeps blood flowing a bit better. Our goal is for there to be blood constantly oozing from the leech site. We also put these patients on a heparin drip, a dextran drip, high flow saline or other maintainance drip, and they stay in an 80 degree room for 5 days to promote vasodilation. We go all out, but once we put a digit back on, it generally stays there. One of the toughest things for these Seattle patients is that we restrict them from having any nicotine or caffeine--so hard when you are used to your Starbucks!!
Alyca

[traumaRUs]

Very interesting - thanks for the info.

[NursesRmofun]

Just saying hello. That is amazing work.