Practical Pointers: Discover Shortcuts Devised by Colleagues (August 2005)
Tie the Knot
You've just finished suturing a laceration on a writhing, screaming toddler, and you notice that the knot is not tight enough. Something must have slipped. To tighten things up a bit, run a loop between the first and last stitch on top of the skin, then cinch up both ends and tie (Figure). If this maneuver fails, you'll need to resuture the laceration.
——D. Brady Pregerson, MD
Los Angeles
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Figure – These 3 photographs show the steps involved in a simple technique for tightening up sutures that have accidentally loosened during stitching. First, run a separate, unattached piece of suture under the first and last stitch (A). Grasp both ends of the suture (B), then cross them (C) as you prepare to cinch them up and tie. | ||
Prewritten Postpartum Prescriptions Save Time
I prewrite prescriptions for docusate sodium and ibuprofen to have on hand when I see patients during the postpartum period. This lets me spend more time with the patient.
——Asha Subramanian, MD
Washington, DC
Cut Casts—and Costs
At over $750, cast saws are expensive. Save money by making one yourself. Simply buy a vibrating detail sander (available from your local woodworking supply store), and fit it with a tile-cutting blade. Total cost: about $75.
——Mike Niziol, MD
Freeville, NY
Solution for a Sticky Summer Situation
Tar on the feet and legs can be an unwelcome consequence of summer trips to the beach. Getting it off can be difficult, painful, and harmful to the underlying tissue. Tell patients they can make removal easier by gently rubbing a small amount of mayonnaise on the affected area. They can then use a clean cloth to remove the tar, which should come off without difficulty. If the tar has burned the skin, advise them to use appropriate first aid for burns.
—— Sheryl Stone Clay, RN, BSN
Mason, Ohio