This might be a stupid question but...

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    One of my patients (child) got a laceration to his forehead about 1 cm long, which had no active bleeding after cleaning the wound. I wasnt sure if he needed sutures to his lac or not. Which made me feel pretty incompetent. But when I think about it I don't ever remember being taught about minor lacerations in nursing school. Was I not there during that lecture or is this one of those things that you learn as you go from years of experince. I know I feel like that at times when it comes to nursing. Can someone help me?
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  3. 9 Comments so far...

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    Probably it's just an experience thing. If there wasn't a lot of bleeding I would just apply steri strips and a simple dressing. Head wounds usually have a lot of being bleeding due to it being so vascular so I gather the wound wasn't too deep.

    There are no stupid questions. I am interested see what others think. I work a mostly elderly population so one of our concerns is if they are on blood thinners.
    Last edit by loriangel14 on Oct 31, '12
    T-Bird78 likes this.
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    quick question, are you asking if you needed to do the sutures? steri strips would come in handy until an eval by a physician if necessary. otherwise as stated, head wounds do bleed alot.
    loriangel14 likes this.
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    I wasn't thinking wound care - I thought about a tetanus inj. Different strokes ...
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    Not a stupid question at all. I hate that I would really suck at basic non emergency first aid.

    Minor burns, minor wound care, nose bleeds, how to be sure if it is a sprain versus a fracture, etc. everything like that I would have to go to the Internet to be sure what I was doing was correct.

    I know we didn't cover it in nursing school, and even if we had I would have forgotten since it doesn't come up in a hospital med/surg setting.

    I keep telling myself I will take a community offered basic first aid class.
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    Super glue also works well in situations like that. For a non-bleeding wound, some type of tight closure is good simply from a scarring perspective.

    And superficial wounds generally have a very low risk of tetanus (which needs an anaerobic environment, such as deep puncture wounds).
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    I read an article just this week stating that minor lacerations don't have any more scarring with bandaids than with stitches. So if the bandaid or equivalent works, use it. There are skin glues available in pharmacies (great for tackle boxes!).

    As for the questions - this is why we exist. We learn from one another
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    " blood thinners."

    Please, everyone, do not use the term "blood thinners," because it makes patients think of water in the milk or turpentine in the paint. Anticoagulants do not thin the blood, they decrease its clotting ability. I know you will hear other nurses and even doctors use this term speaking to patients because they think "anticoagulant" is a big scary/confusing word. They are wrong to do so. I've heard people say that they are always cold when they take warfarin because they have thin blood. Obviously not the case, so someone has missed the boat on patient teaching and this resulted in confusion they tried to avoid.


    Think about your patient teaching: If you are teaching someone about his anticoagulant medications, how do you reinforce the idea of why he takes them if he thinks it has to do with thinning blood and not making clots?


    "Your heartbeat is irregular, atrial fibrillation, and that increases the chances that a blood clot will form in your heart. (Or, "You have a tendency to form clots in the deep veins in your leg. These could travel to your heart and be dangerous.") So we give you this medication to decrease your clotting. We test your blood every X days/weeks/months to see that the dose is still correct, by looking at how long your blood takes to clot. Whileyou are taking this medication, called an "anticoagulant," your blood will not clot as fast as normal, so you should avoid things that might result in injury like ..... You should look out for easy bruising or bleeding, or bleeding that doesn't stop, black in your stools or if you vomit blood; tell your healthcare provider right away."


    Is that so hard? Get in the habit of doing it right in the first place and you won't have to change your language later.

    Ahem. To return to your forehead lac-- clean it and steristrip it together. Confirm tetanus immunization status. Lollipop. Discharge.
    peterm2 likes this.
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    Quote from classicdame
    I read an article just this week stating that minor lacerations don't have any more scarring with bandaids than with stitches. So if the bandaid or equivalent works, use it. There are skin glues available in pharmacies (great for tackle boxes!).

    As for the questions - this is why we exist. We learn from one another
    Protip: That New-Skin stuff sold at pharmacies is exactly the same as super-glue.

    Source: Boyfriend went into their facility to do some industrial type welding on their vats they make it in. Two different vats (Newskin, regular superglue) in the same room- he asked what the difference was- they told him: "Price."
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    We use some sort of closure if the wound gaps independent of any bleeding. Able to approximate well and not somewhere with a lot of movement and stretching? Dermabond. Jagged or the skin moves and stretches a lot? Sutures. Scalp wound? Staples.


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